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Sample records for nursing intervention protocol

  1. Pilot testing of intervention protocols to prevent pneumonia in nursing home residents.

    PubMed

    Quagliarello, Vincent; Juthani-Mehta, Manisha; Ginter, Sandra; Towle, Virginia; Allore, Heather; Tinetti, Mary

    2009-07-01

    To test intervention protocols for feasibility, staff adherence, and effectiveness in reducing pneumonia risk factors (impaired oral hygiene, swallowing difficulty) in nursing home residents. Prospective study. Two nursing homes. Fifty-two nursing home residents. Thirty residents with impaired oral hygiene were randomly assigned to manual oral brushing plus 0.12% chlorhexidine oral rinse at different frequencies daily. Twenty-two residents with swallowing difficulty were randomly assigned to upright feeding positioning, teaching swallowing techniques, or manual oral brushing. All protocols were administered over 3 months. Feasibility was assessed monthly and defined as high if the protocol took less than 10 minutes to administer. Adherence was assessed weekly and defined as high if full staff adherence was demonstrated in more than 75% of assessments. Effectiveness for improved oral hygiene (reduction in oral plaque score) and swallowing (reduction in cough during swallowing) was compared at baseline and 3 months. Daily manual oral brushing plus 0.12% chlorhexidine rinse demonstrated high feasibility, high staff adherence, and effectiveness in improving oral hygiene (P<.001 vs baseline); this combination administered twice per day showed the highest plaque score reduction. Daily manual oral brushing and upright feeding positioning demonstrated high feasibility, high staff adherence, and effectiveness in improving swallowing. Manual oral brushing, 0.12% chlorhexidine oral rinse, and upright feeding positioning demonstrated high feasibility, high staff adherence, and effectiveness in pneumonia risk factor reduction. A protocol combining these components warrants testing for its ability to reduce pneumonia in nursing home residents.

  2. Pilot Testing of Intervention Protocols to Prevent Pneumonia among Nursing Home Residents

    PubMed Central

    Quagliarello, Vincent; Juthani-Mehta, Manisha; Ginter, Sandra; Towle, Virginia; Allore, Heather; Tinetti, Mary

    2009-01-01

    Objectives To test intervention protocols for feasibility, staff adherence and effectiveness in reducing pneumonia risk factors (i.e., impaired oral hygiene, swallowing difficulty) in nursing home residents. Design Prospective study. Setting Two nursing homes. Participants Fifty-two nursing home residents. Interventions Thirty residents with impaired oral hygiene were randomly assigned to manual oral brushing + 0.12% chlorhexidine oral rinse at different frequencies daily. Twenty-two residents with swallowing difficulty were randomly assigned to upright feeding positioning, teaching swallowing techniques, or manual oral brushing. All protocols were administered over 3 months. Measurements Feasibility was assessed monthly and defined as high if the protocol took < 10 minutes to administer. Adherence was assessed weekly and defined as high if full staff adherence was demonstrated in >75% of assessments. Effectiveness for improved oral hygiene (i.e., reduction in oral plaque score) and swallowing (i.e., reduction in cough during swallowing) was assessed at 3 months compared to baseline. Results Daily manual oral brushing + 0.12% chlorhexidine rinse demonstrated high feasibility, high staff adherence and effectiveness in improving oral hygiene (p<0.001 compared to baseline); this combination administered twice per day showed the highest plaque score reduction. Daily manual oral brushing and upright feeding positioning demonstrated high feasibility, high staff adherence, and effectiveness in improving swallowing. Conclusion Manual oral brushing, 0.12% chlorhexidine oral rinse, and upright feeding positioning demonstrated high feasibility, high staff adherence, and effectiveness in pneumonia risk factor reduction. A protocol combining these components warrants testing for its ability to reduce pneumonia among nursing home residents. PMID:19558483

  3. Pain Intervention for people with Dementia in nursing homes (PID): study protocol for a quasi-experimental nurse intervention.

    PubMed

    Koppitz, Andrea; Bosshard, Georg; Blanc, Geneviève; Hediger, Hannele; Payne, Sheila; Volken, Thomas

    2017-04-21

    It is estimated that 19 to 83% of people with dementia suffer from pain that is inadequately treated in the last months of life. A large number of healthcare workers who care for these people in nursing homes lack appropriate expertise and may therefore not always recognise, assess and treat pain in those with dementia who have complex problems on time, properly and efficiently. The aim of this intervention trial is to identify care needs of people with dementia suffering from pain living in a nursing home. A quasi-experimental nurse-led intervention trial based on a convenience sample of four nursing homes in the Swiss Canton of Zurich examines the effects on dementia patients (n = 411), the healthcare institution and the qualification level of the healthcare workers compared to historical controls, using an event analysis and a multilevel analysis. Healthcare workers will be individually trained how to assess, intervene and evaluate acute and chronic pain. There are three data-monitoring cycles (T0, T1, T2) and two intervention cycles (I1, I2) with a total study duration of 425 days. There is also a process evaluation based on Dobbins analyses that analyse in particular the potentials for change in clinical practice of change agents. The aim of the intervention trial is to improve pain management strategies in older people with dementia in nursing homes. Clinically significant findings will be expected that will help reduce suffering in the sense of "total pain" for people with dementia. The joint intra- and interdisciplinary collaboration between practice and supply-oriented (nursing) research will have both a lasting effect on the efficiency measurement and provide scientifically sound results. Nursing homes can integrate the findings from the intervention trial into their internal quality control process. The potential for improvements can be directly influenced by the nursing home itself. Registration trial number: DRKS00009726 on DRKS, registered 10

  4. A Cluster-Randomized Controlled Trial of a Multicomponent Intervention Protocol for Pneumonia Prevention Among Nursing Home Elders

    PubMed Central

    Juthani-Mehta, Manisha; Van Ness, Peter H.; McGloin, Joanne; Argraves, Stephanie; Chen, Shu; Charpentier, Peter; Miller, Laura; Williams, Kathleen; Wall, Diane; Baker, Dorothy; Tinetti, Mary; Peduzzi, Peter; Quagliarello, Vincent J.

    2015-01-01

    Background. Pneumonia remains an important public health problem among elderly nursing home residents. This clinical trial sought to determine if a multicomponent intervention protocol, including manual tooth/gum brushing plus 0.12% chlorhexidine oral rinse, twice per day, plus upright positioning during feeding, could reduce the incidence of radiographically documented pneumonia among nursing home residents, compared with usual care. Methods. This cluster-randomized clinical trial was conducted in 36 nursing homes in Connecticut. Eligible residents >65 years with at least 1 of 2 modifiable risk factors for pneumonia (ie, impaired oral hygiene, swallowing difficulty) were enrolled. Nursing homes were randomized to the multicomponent intervention protocol or usual care. Participants were followed for up to 2.5 years for development of the primary outcome, a radiographically documented pneumonia, and secondary outcome, a lower respiratory tract infection (LRTI) without radiographic documentation. Results. A total of 834 participants were enrolled: 434 to intervention and 400 to usual care. The trial was terminated for futility. The number of participants in the intervention vs control arms with first pneumonia was 119 (27.4%) vs 94 (23.5%), respectively, and with first LRTI, 125 (28.8%) vs 100 (25.0%), respectively. In a multivariable Cox regression model, the hazard ratio in the intervention vs control arms, respectively, was 1.12 (95% confidence interval [CI], .84–1.50; P = .44) for first pneumonia and 1.07 (95% CI, .79–1.46, P = .65) for first LRTI. Conclusions. The multicomponent intervention protocol did not significantly reduce the incidence of first radiographically confirmed pneumonia or LRTI compared with usual care in nursing home residents. Clinical Trials Registration. NCT00975780. PMID:25520333

  5. Correctional nursing: a study protocol to develop an educational intervention to optimize nursing practice in a unique context

    PubMed Central

    2013-01-01

    Background Nurses are the primary healthcare providers in correctional facilities. A solid knowledge and expertise that includes the use of research evidence in clinical decision making is needed to optimize nursing practice and promote positive health outcomes within these settings. The institutional emphasis on custodial care within a heavily secured, regulated, and punitive environment presents unique contextual challenges for nursing practice. Subsequently, correctional nurses are not always able to obtain training or ongoing education that is required for broad scopes of practice. The purpose of the proposed study is to develop an educational intervention for correctional nurses to support the provision of evidence-informed care. Methods A two-phase mixed methods research design will be used. The setting will be three provincial correctional facilities. Phase one will focus on identifying nurses’ scope of practice and practice needs, describing work environment characteristics that support evidence-informed practice and developing the intervention. Semi-structured interviews will be completed with nurses and nurse managers. To facilitate priorities for the intervention, a Delphi process will be used to rank the learning needs identified by participants. Based on findings, an online intervention will be developed. Phase two will involve evaluating the acceptability and feasibility of the intervention to inform a future experimental design. Discussion The context of provincial correctional facilities presents unique challenges for nurses’ provision of care. This study will generate information to address practice and learning needs specific to correctional nurses. Interventions tailored to barriers and supports within specific contexts are important to enable nurses to provide evidence-informed care. PMID:23799894

  6. Effectiveness of a mobile cooperation intervention during the clinical practicum of nursing students: a parallel group randomized controlled trial protocol.

    PubMed

    Strandell-Laine, Camilla; Saarikoski, Mikko; Löyttyniemi, Eliisa; Salminen, Leena; Suomi, Reima; Leino-Kilpi, Helena

    2017-06-01

    The aim of this study was to describe a study protocol for a study evaluating the effectiveness of a mobile cooperation intervention to improve students' competence level, self-efficacy in clinical performance and satisfaction with the clinical learning environment. Nursing student-nurse teacher cooperation during the clinical practicum has a vital role in promoting the learning of students. Despite an increasing interest in using mobile technologies to improve the clinical practicum of students, there is limited robust evidence regarding their effectiveness. A multicentre, parallel group, randomized, controlled, pragmatic, superiority trial. Second-year pre-registration nursing students who are beginning a clinical practicum will be recruited from one university of applied sciences. Eligible students will be randomly allocated to either a control group (engaging in standard cooperation) or an intervention group (engaging in mobile cooperation) for the 5-week the clinical practicum. The complex mobile cooperation intervention comprises of a mobile application-assisted, nursing student-nurse teacher cooperation and a training in the functions of the mobile application. The primary outcome is competence. The secondary outcomes include self-efficacy in clinical performance and satisfaction with the clinical learning environment. Moreover, a process evaluation will be undertaken. The ethical approval for this study was obtained in December 2014 and the study received funding in 2015. The results of this study will provide robust evidence on mobile cooperation during the clinical practicum, a research topic that has not been consistently studied to date. © 2016 John Wiley & Sons Ltd.

  7. [Classification of nursing interventions].

    PubMed

    Guimarães, H C; Barros, A L

    2001-06-01

    During the last years, Nursing is seeking to classify its diagnoses, interventions/actions and outcomes. Here is presented one of the classifications of nursing interventions that was proposed by nurses of the University of Iowa in 1987, the Nursing Interventions Classifications (NIC) as well as the reasons os its creation, in order to contribute to the dissemination of one of the most advanced proposals for classifying nursing interventions.

  8. The OPERA trial: protocol for a randomised trial of an exercise intervention for older people in residential and nursing accommodation

    PubMed Central

    2011-01-01

    Abstract Background Depression is common in residents of Residential and Nursing homes (RNHs). It is usually undetected and often undertreated. Depression is associated with poor outcomes including increased morbidity and mortality. Exercise has potential to improve depression, and has been shown in existing trials to improve outcomes among younger and older people. Existing evidence comes from trials that are short, underpowered and not from RNH settings. The aim of the OPERA trial is to establish whether exercise is effective in reducing the prevalence of depression among older RNH residents. Method OPERA is a cluster randomised controlled trial. RNHs are randomised to one of two groups with interventions lasting 12 months Intervention group: a depression awareness and physical activity training session for care home staff, plus a whole home physical activation programme including twice weekly physiotherapist-led exercise groups. The intervention lasts for one year from randomisation, or Control group: a depression awareness training session for care home staff. Participants are people aged 65 or over who are free of severe cognitive impairment and willing to participate in the study. Our primary outcome is the prevalence of depressive symptoms, a GDS-15 score of five or more, in all participants at the end of the one year intervention period. Our secondary depression outcomes include remission of depressive symptoms and change in GDS-15 scores in those with depressive symptoms prior to randomisation. Other secondary outcomes include, fear of falling, mobility, fractures, pain, cognition, costs and health related quality of life. We aimed to randomise 77 RNHs. Discussion Home recruitment was completed in May 2010; 78 homes have been randomised. Follow up will finish in May 2011 and results will be available late 2011. Trial Registration [ISRCTN: ISRCTN43769277] PMID:21288340

  9. Implementation of radial arterial access for cardiac interventions: a strong case for quality assurance protocols by the nursing staff.

    PubMed

    Steffenino, Giuseppe; Fabrizi, Mauro De Benedetto; Baralis, Giorgio; Tomatis, Marilena; Mogna, Aldo; Dutto, Monica; Dutto, Maria Stefania; Conte, Laura; Lice, Giulietta; Cavallo, Simona; Porcedda, Brunella

    2011-02-01

    Radial arterial access is becoming increasingly popular for coronary angiography and angioplasty. The technique is, however, more demanding than femoral arterial access, and hemostasis is not care-free. A quality assurance program was run by our nursing staff, with patient follow-up, to monitor radial arterial access implementation in our laboratory. In 973 consecutive patients, both a hydrophilic sheath and an inflatable bandage for hemostasis were used. Bandage inflation volume and time were both reduced through subsequent data audit and protocol changes (A = 175 patients; B = 297; C = 501). An increase was achieved in the percentage of patients with neither loss of radial pulse nor hematoma of any size (A = 81.3%, B = 90.9%, C = 92.2%, P < 0.001), and no discomfort at all (A = 44.2%, B = 75.1%, C = 89.3%, P < 0.001). Follow-up was available for 965 patients (99%), and in 956, the access site could be re-inspected at least once. There were no vascular complications. Overall, the radial artery pulse was absent at latest follow-up in 0.6% of cases (95% confidence interval 0.21-1.05%). In 460 consecutive patients with complete assessment in protocol C, a palpable arterial pulse was absent in 5% of cases at about 20 h after hemostasis. Barbeau's test was positive in 26.5% of patients (95% confidence interval 22.5-30.6%). They had a significantly lower body weight, a lower systolic blood pressure at hemostasis, and a higher bandage inflation volume; a hematoma of any size and the report of any discomfort were also more frequent. Barbeau's test returned to normal in 30% of them 3-60 days later. Our nurse-led quality assurance program helped us in reducing minor vascular sequelae and improving patient comfort after radial access. Early occlusion of the radial artery as detected by pulse oxymeter is frequent, often reversible, and may be mostly related to trauma/occlusion of the artery during hemostasis. 2011 Italian Federation of Cardiology.

  10. Implementation of a Multicomponent intervention to Prevent Physical Restraints In Nursing home residenTs (IMPRINT): study protocol for a cluster-randomised controlled trial.

    PubMed

    Abraham, Jens; Möhler, Ralph; Henkel, Adrienne; Kupfer, Ramona; Icks, Andrea; Dintsios, Charalabos-Markos; Haastert, Burkhard; Meyer, Gabriele; Köpke, Sascha

    2015-07-21

    Physical restraints such as bedrails and belts are regularly applied in German nursing homes despite clear evidence showing their lack of effectiveness and safety. In a cluster-randomised controlled trial, the efficacy and safety of a guideline-based multicomponent intervention programme has been proven. The present study aims to evaluate the effectiveness of two different versions of the original intervention in nursing home residents in four different regions throughout Germany. The study is a pragmatic cluster-randomised controlled trial comparing two intervention groups, i.e. (1) the updated original multicomponent intervention programme and (2) the concise version of the updated programme, with a control group receiving optimised usual care. The first intervention group receives an educational programme for all nurses, additional training and structured support for nominated key nurses, printed study material and other supportive material. In the second intervention group, nurses do not receive education as part of the intervention, but may be trained by nominated key nurses who have received a short train-the-trainer module. All other components are similar to the first intervention group. The control group receives the printed study material only. Overall, 120 nursing homes including approximately 10,800 residents will be recruited and randomly assigned to one of the three groups. The primary outcome is defined as the proportion of residents with at least one physical restraint after 12 months follow-up. The use of physical restraints will be assessed by direct observation. Secondary outcomes are the residents' quality of life and safety parameters, e.g. falls and fall-related fractures. In addition, comprehensive process and economic evaluations will be performed. We expect a clinically relevant reduction in the proportion of residents with physical restraints. It is also expected that the process outcomes of this trial will enrich the knowledge about

  11. Dissemination of the nurse-administered Tobacco Tactics intervention versus usual care in six Trinity community hospitals: study protocol for a comparative effectiveness trial

    PubMed Central

    2012-01-01

    Background The objectives of this smoking cessation study among hospitalized smokers are to: 1) determine provider and patient receptivity, barriers, and facilitators to implementing the nurse-administered, inpatient Tobacco Tactics intervention versus usual care using face-to-face feedback and surveys; 2) compare the effectiveness of the nurse-administered, inpatient Tobacco Tactics intervention versus usual care across hospitals, units, and patient characteristics using thirty-day point prevalence abstinence at thirty days and six months (primary outcome) post-recruitment; and 3) determine the cost-effectiveness of the nurse-administered, inpatient Tobacco Tactics intervention relative to usual care including cost per quitter, cost per life-year saved, and cost per quality-adjusted life-year saved. Methods/Design This effectiveness study will be a quasi-experimental design of six Michigan community hospitals of which three will get the nurse-administered Tobacco Tactics intervention and three will provide their usual care. In both the intervention and usual care sites, research assistants will collect data from patients on their smoking habits and related variables while in the hospital and at thirty days and six months post-recruitment. The intervention will be integrated into the experimental sites by a research nurse who will train Master Trainers at each intervention site. The Master Trainers, in turn, will teach the intervention to all staff nurses. Research nurses will also conduct formative evaluation with nurses to identify barriers and facilitators to dissemination. Descriptive statistics will be used to summarize the results of surveys administered to nurses, nurses’ participation rates, smokers’ receipt of specific cessation services, and satisfaction with services. General estimating equation analyses will be used to determine differences between intervention groups on satisfaction and quit rates, respectively, with adjustment for the clustering

  12. A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.

    PubMed

    Borglin, Gunilla; Gustafsson, Markus; Krona, Hans

    2011-09-23

    Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pain management have shown promise. As cancer-related pain is also known to have a negative effect on vital aspects of the patient's life, as well as being commonly associated with problems such as sleep, fatigue, depression and anxiety, further development of knowledge within this area is warranted. A quasi-experimental study design will be used to investigate whether the implementation of guidelines for systematic daily pain assessments following a theory-based educational intervention will result in an improvement in knowledge and attitude among nurses. A further aim is to investigate whether the intervention that targets nurses' behaviour will improve hospital patients' perception of pain. Data regarding nurses' knowledge and attitudes to pain (primary outcome), patient perception regarding pain (secondary outcome), together with socio-demographic variables, will be collected at baseline and at four weeks and 12 weeks following the intervention. Nursing care is nowadays acknowledged as an increasingly complicated activity and "nursing complexity is such that it can be seen as the quintessential complex intervention." To be able to change and improve clinical practice thus requires multiple points of attack appropriate to meet complex challenges. Consequently, we expect the theory-based intervention used in our quasi-experimental study to improve care as well as quality of life for this group of patients and we also envisage that evidence-based guidelines targeting this patient group's pain

  13. Nursing interventions in inpatient psychiatry.

    PubMed

    Frauenfelder, F; Müller-Staub, M; Needham, I; van Achterberg, T

    2013-12-01

    The successful application of the Nursing Interventions Classification (NIC) in inpatient psychiatry depends on whether the classification adequately describes nursing care in this setting. The present study aimed to identify nursing interventions mentioned in journal articles on psychiatric inpatient nursing care and to compare these with the labels, definitions and activities described in the NIC to elucidate how well the classification covers these interventions. The MedLine, PsychInfo, Cochrane and CINAHL databases were searched for journal articles about nursing care in the adult inpatient setting. A qualitative content analysis approach was used to indentify nursing interventions in the articles. About 84% of the statements (terms and definitions) are encompassed by the interventions listed by the NIC. Very few interventions need to be added to the NIC classification or necessitate a reorganization of the taxonomy. Nevertheless, the further development of the NIC will promote its use in the daily work of psychiatric nurses and enhance the quality of nursing care in the inpatient setting. © 2013 John Wiley & Sons Ltd.

  14. Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol

    PubMed Central

    Müller, Martin; Bartoszek, Gabriele; Beutner, Katrin; Klingshirn, Hanna; Saal, Susanne; Stephan, Anna-Janina; Strobl, Ralf; Grill, Eva; Meyer, Gabriele

    2015-01-01

    Background: Joint contractures are common problems in frail older people in nursing homes. Irrespective of the exact extent of older individuals in geriatric care settings living with joint contractures, they appear to be a relevant problem. Also, the new emphasis on the syndrome of joint contractures, e. g. by the German statutory long term care insurance, led to an increase in assessment and documentation efforts and preventive interventions in clinical care. However, more attention should be paid to the actual situation of older individuals in nursing homes with prevalent joint contractures, particularly their experience of related activity limitations and participation restrictions. Thus, the aim of this study is 1) to develop a tailored intervention to improve functioning, and especially participation and quality of life in older residents with joint contractures in nursing homes and 2) to test the feasibility of the intervention accompanied by a rigorous process evaluation. Methods: The complex intervention, which will be developed in this project follows the UK Medical Research Council (MRC) framework and integrates the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development process will comprise a systematic literature review, reanalysis of existing data and the integration of the knowledge of the affected individuals and experts. The developed intervention including a comprehensive process evaluation will be pilot tested with residents with joint contractures in three nursing homes. Discussion: The projected study will provide a tailored intervention to improve functioning, participation and quality of life in older residents with joint contractures in nursing homes. With this focus, the intervention will support patient relevant outcomes. The pilot study including process evaluation will offer a first opportunity to indicate the size of the intervention’s effect and prepare

  15. Nurse driven protocol for head injured patients on warfarin.

    PubMed

    Bair, Holly; Ivascu, Felicia; Janczyk, Randy; Nittis, Tara; Bendick, Philip; Howells, Greg

    2005-01-01

    The trauma quality improvement committee at our facility identified a significant number of patients on warfarin presenting to the emergency center after minor head trauma that subsequently expired from their intracranial hemorrhage prior to appropriate intervention. An analysis of this patient population identified multiple areas of delay. A collaborative effort between the emergency center nurses and the trauma service personnel resulted in a formal protocol to address each component of delay and expedite the process. Since implementation of this nursing driven protocol we have dramatically decreased the time to (1) Emergency Center Physician evaluation, (2) completion of head computerized tomography, (3) reversal of anticoagulation with fresh frozen plasma (FFP), and (4) most importantly, patient mortality rate. We conclude that this nursing driven protocol is effective in decreasing the mortality rate by eliminating diagnostic and therapeutic delays in this high-risk patient population.

  16. Public Health Interventions for School Nursing Practice

    ERIC Educational Resources Information Center

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  17. Public Health Interventions for School Nursing Practice

    ERIC Educational Resources Information Center

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  18. Crisis intervention for nurses.

    PubMed

    Chase, Emily

    2013-06-01

    Cancer diagnoses and treatments can be crisis-causing events that overwhelm the usual coping abilities of patients and their families. Oncology nurses constantly are observing and attending to patients' diverse needs, ranging from biomedical to emotional, social, and psychological. Nurses have the chance to be first responders in times of patient crises, as they are in the position to recognize the crisis, respond effectively, and transform the crisis into a pivotal learning experience. This article discusses a way to think about patient and family crises that empowers nurses to respond in a manner appropriate to the cultural context and respectful of the individual space of the patient.

  19. [Cooperation protocols, which concept for nursing care?].

    PubMed

    Le Boeuf, Dominique

    2010-12-01

    The implementation of cooperation protocols as provided for by the "Hospital, patients, health and regions" Law may greatly alter the organisation of healthcare practices. But an excessively limited vision, focused on the medical act to be delegated, might remove the clinical aspect of the nurse's role and reduce it to merely executing prescriptions. The French National Order of Nurses, through the opinions it will give to national health Authorities, wishes to prevent this danger.

  20. Developing practice protocols for advanced practice nursing.

    PubMed

    Paul, S

    1999-08-01

    In most states, the role of an advanced practice nurse is dependent on practice protocols that provide an organized method for analyzing and managing a disease or major symptom. They are also used to control the process of medical care and to specify steps in the delivery of that care. Creating appropriate practice protocols is one of the most important precursors to implementing the advanced practice role, because they virtually drive the clinician's ability to treat or manage clinical situations or disease states. This article outlines the steps involved in developing practice protocols and discusses the content that should be included in a protocol, providing an example of narrative and algorithm format protocols. Pros and cons, as well as legal issues related to practice protocols, are also presented.

  1. Impact on quality of life of a nursing intervention programme for patients with chronic non-cancer pain: an open, randomized controlled parallel study protocol.

    PubMed

    Morales-Fernandez, Angeles; Morales-Asencio, Jose Miguel; Canca-Sanchez, Jose Carlos; Moreno-Martin, Gabriel; Vergara-Romero, Manuel

    2016-05-01

    To determine the effect of a nurse-led intervention programme for patients with chronic non-cancer pain. Chronic non-cancer pain is a widespread health problem and one that is insufficiently controlled. Nurses can play a vital role in pain management, using best practices in the assessment and management of pain under a holistic approach where the patient plays a proactive role in addressing the disease process. Improving the quality of life, reducing disability, achieving acceptance of health status, coping and breaking the vicious circle of pain should be the prime objectives of our care management programme. Open randomized parallel controlled study. The experimental group will undertake one single initial session, followed by six group sessions led by nurses, aimed at empowering patients for the self-management of pain. Healthy behaviours will be encouraged, such as sleep and postural hygiene, promotion of physical activity and healthy eating. Educational interventions on self-esteem, pain-awareness, communication and relaxing techniques will be carried out. As primary end points, quality of life, perceived level of pain, anxiety and depression will be evaluated. Secondary end points will be coping and satisfaction. Follow-up will be performed at 12 and 24 weeks. The study was approved by the Ethics and Research Committee Costa del Sol. If significant effects were detected, impact on quality of life through a nurse-led programme would offer a complementary service to existing pain clinics for a group of patients with frequent unmet needs. © 2016 John Wiley & Sons Ltd.

  2. Mentorship in nursing academia: a systematic review protocol.

    PubMed

    Nowell, Lorelli; White, Deborah E; Mrklas, Kelly; Norris, Jill M

    2015-02-21

    Mentorship is perceived as vital to attracting, training, and retaining nursing faculty members and to maintaining high-quality education programs. While there is emerging evidence to support the value of mentorship in academic medicine, the extant state of the evidence for mentorship in nursing academia has not been established. We describe a protocol for a mixed-methods systematic review to critically appraise the evidence for mentorship in nursing academia. Studies examining the effectiveness of mentorship interventions with nursing faculty who teach in registered nursing education programs will be included. Mentee, mentor, and nursing education institutional outcomes will be explored. Quantitative, qualitative, and mixed method studies will be eligible for inclusion, without restrictions on publication status, year of publication, or language. We will search electronic databases (for example, MEDLINE, CINAHL, ERIC) and gray literature (for example, conference proceedings, key journals, relevant organizational websites) for relevant citations. Using pilot-tested screening and data extraction forms, two reviewers will independently review the studies in three steps: (1) abstract/title screening, (2) full-text screening of accepted studies, and (3) data extraction of accepted studies. Studies will be aggregated for meta-synthesis (qualitative) and meta-analysis (quantitative), should the data permit. This study is the first systematic review of existing global evidence for mentorship in nursing academia. It will help identify key evidence gaps and inform the development and implementation of mentorship interventions. The mentorship outcomes that result from this review could be used to guide the practice of mentorship to increase positive outcomes for nursing faculty and the students they teach and ultimately effect improvements for the patients they care for. This review will also identify key considerations for future research on mentorship in nursing academia

  3. Animal-Assisted Interventions in Dutch Nursing Homes: A Survey.

    PubMed

    Schuurmans, Lonneke; Enders-Slegers, Marie-Jose; Verheggen, Theo; Schols, Jos

    2016-07-01

    Animal-assisted interventions (AAI) have become more and more popular in nursing homes in the past decade. Various initiatives for using animals in nursing homes have been developed over the years (eg, animal visiting programs, residential companion animals, petting zoos) and, on the whole, the number of nursing homes that refuse animals on their premises has declined. In this survey, we aimed to determine how many Dutch nursing homes offer AAIs, what type of interventions are used, and with what aim. We also focus on the use of underlying health, hygiene, and (animal) safety protocols. Using an online Dutch nursing home database, we invited all listed (457) nursing home organizations in the Netherlands (encompassing a total of 804 nursing home locations) to participate in our digital survey, powered by SurveyMonkey. The survey consisted of a total of 45 questions, divided into general questions about the use of animals in interventions; the targeted client population(s); and specific questions about goals, guidelines, and protocols. The results were analyzed with SPSS Statistics. In the end, 244 surveys, representing 165 organizations, were returned: 125 nursing homes used AAI in one way or another, 40 did not. Nursing homes that did not offer AAI cited allergy and hygiene concerns as the most important reasons. Most nursing homes offering AAI used visiting animals, mostly dogs (108) or rabbits (76). A smaller number of nursing homes had resident animals, either living on the ward or in a meadow outside. Almost all programs involved animal-assisted activities with a recreational purpose; none of the participating nursing homes provided animal assisted therapy with therapeutic goals. Psychogeriatric patients were most frequently invited to participate. A total of 88 nursing homes used alternatives when animals were not an option or not available. The most popular alternative was the use of stuffed animals (83) followed by FurReal Friends robotic toys (14). The

  4. Public Health Interventions for School Nursing Practice.

    PubMed

    Schaffer, Marjorie A; Anderson, Linda J W; Rising, Shannon

    2016-06-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic survey on their use of public health interventions as defined by the wheel. Although 67% of the participants were not familiar with the Public Health Intervention Wheel, respondents reported conducting activities that were consistent with the Wheel interventions. Screening, referral and follow-up, case management, and health teaching were the most frequently performed interventions. Intervention use varied by educational level, age of nurse, years of practice, and student population. The Public Health Intervention Wheel is a relevant and useful framework that provides a language to explain population-based school nursing practice.

  5. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol.

    PubMed

    Bunker, Jeremy M; Reddel, Helen K; Dennis, Sarah M; Middleton, Sandy; Van Schayck, Cp; Crockett, Alan J; Hasan, Iqbal; Hermiz, Oshana; Vagholkar, Sanjyot; Marks, Guy B; Zwar, Nicholas A

    2012-09-07

    Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP) team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD.The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate), smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities.The primary outcome measure is health-related quality of life, assessed with the St George's Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related quality of life measures, smoking and immunisation

  6. Nursing burnout interventions: what is being done?

    PubMed

    Henry, Barbara J

    2014-04-01

    Many studies have documented high prevalence of burnout and compassion fatigue in oncology nurses. Burnout has detrimental effects on nurses, patients, and healthcare organizations. However, burnout interventions have been shown to improve the physical and mental health of nurses, patient satisfaction, and the organizational bottom line by reducing associated costs of burnout. Although treatment centers may prevent and correct burnout in oncology nurses by providing various interventions, few articles focus on those interventions. This article compiles and describes interventions that will serve as a reference to nurses and healthcare organization leaders interested in implementing similar programs.

  7. Korean hospice nursing interventions using the Nursing Interventions Classification system: a comparison with the USA.

    PubMed

    Hong, Sung-Jung; Lee, Eunjoo

    2014-12-01

    In this study, nursing interventions used by hospice nurses in Korea were identified and compared with core interventions selected by US end-of-life care nurses in order to determine similarities and differences between the two nations regarding such care. Data were collected from the electronic medical records of 353 hospice patients admitted to a tertiary hospital in Korea over a period of two years. First, extracted narrative interventions were mapped onto the Nursing Interventions Classification for comparison with interventions selected by nurses in the USA. A total of 56,712 intervention statements were mapped onto 147 Nursing Interventions Classification interventions. Hospice nurses in Korea performed more nursing interventions in the physiological basic domain, compared to nurses in the USA. The most frequently-used interventions in Korea were related to patient pain management. Among 47 core Nursing Interventions Classification interventions used in the USA, only 18 were used by Korean nurses in this study. This study highlights cultural differences in hospice care nursing interventions between the two countries. © 2014 Wiley Publishing Asia Pty Ltd.

  8. Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study

    PubMed Central

    Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris

    2016-01-01

    ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p < .01). Protocol adaptations addressed barriers (e.g., health records approval, creating pocket versions, distributing with telephone messages). Chart audits revealed that protocols used were documented for 11% to 47% of patient calls. Sustained use requires organizational alignment and ongoing leadership support. Linking Evidence to Action Protocol uptake was similar to trials that have evaluated tailored interventions to improve professional practice by overcoming identified barriers. Collaborating with knowledge users facilitated interpretation of findings, aided protocol adaptation, and supported implementation. Protocol implementation in nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use

  9. Identifying Nursing Interventions in a Cancer Screening Program Using Nursing Interventions Classification Taxonomy.

    PubMed

    Benito, Llucia; Lluch, María Teresa; Falcó, Anna Marta; García, Montse; Puig, Montse

    2017-04-01

    This study aimed to investigate which Nursing Interventions Classification (NIC) labels correspond to specific nursing interventions provided during cancer screening to establish a nursing documentation system. This descriptive study was conducted to identify and classify the interventions that cancer screening nurses perform based on an initial list. The initial list was grouped into 15 interventions that corresponded to four domains and eight classes. The study found expert consensus regarding the duties of cancer screening nurses and identified 15 interventions that should be implemented in clinical practice for cancer screening care, according to the NIC taxonomy. This study is the first step in developing indicators to assess nursing performance in cancer screening, and it helps to establish the core competency requirements for cancer screening nurses. © 2015 NANDA International, Inc.

  10. Documented Nursing Interventions in Inpatient Psychiatry.

    PubMed

    Frauenfelder, Fritz; van Achterberg, Theo; Müller-Staub, Maria

    2016-09-06

    This study explored how well the Nursing Interventions Classification (NIC) covers adult inpatient psychiatric care. By systematic analyses and a mapping approach, documented nursing interventions were assessed on concurrencies with the NIC. From 2,153 intervention descriptions in nursing notes, 1,924 were recognizable as NIC interventions, and 229 did not match the NIC. 89.4% of all identified descriptions of interventions were recognizable as NIC interventions on the level of definition. This study demonstrates that the NIC describes adult inpatient psychiatric care to a large extent. Nevertheless, further development of the classification is important. The study results provide a basis for further developing the NIC and to reinforce its use in inpatient psychiatric settings. © 2016 NANDA International, Inc.

  11. Nursing Interventions Core to Specialty Practice.

    ERIC Educational Resources Information Center

    McCloskey, Joanne Comi; Donahue, William; Bulechek, Gloria M.

    1998-01-01

    The identification of nursing interventions that are core to each clinical specialty will be useful in the development of nursing information systems, staff education programs and evaluations, referral networks, certification and licensing examinations, curricula, and research and theory construction. (Author/JOW)

  12. Conducting Nursing Intervention Research in a Cooperative Group Setting – A Gynecologic Oncology Group (GOG) Experience

    PubMed Central

    Donovan, Heidi S.; Nolte, Susan; Edwards, Robert P.; Wenzel, Lari

    2014-01-01

    Objectives To provide a history on nursing science within the Gynecology Oncology Group (GOG); to discuss challenges and facilitators of nursing science in the cooperative group (CG) using a current nurse-led protocol (GOG-0259) as an exemplar; and to propose recommendations aimed at advancing nursing science in the CG setting. Data Source GOG reports and protocol databases, online databases of indexed citations, and experiences from the development and implementation of GOG-0259. Conclusions Benefits of CG research include opportunities for inter-disciplinary collaboration and ability to rapidly accrue large national samples. Challenges include limited financial resources to support non-treatment trials, a cumbersome protocol approval process, and lack of experience with nursing/quality of life intervention studies. Formal structures within GOG need to be created to encourage nurse scientists to become active members; promote collaboration between experienced GOG advanced practice nurses and new nurse scientists to identify nursing research priorities; and consider innovative funding structures to support pilot intervention studies. Implications for Nursing Practice Understanding the CG research process is critical for nurse scientists. A multi-disciplinary team of CG leaders can help investigators navigate a complex research environment and can increase awareness of the value of nursing research. PMID:24559780

  13. Nurse-driven protocols for febrile pediatric oncology patients.

    PubMed

    Dobrasz, Gina; Hatfield, Marianne; Jones, Laura Masak; Berdis, Jennifer Joan; Miller, Erin Elizabeth; Entrekin, Melanie Smith

    2013-05-01

    Infection is a frequent complication experienced by many children with cancer, with potentially life-threatening consequences that may result in hospitalization, prolonged length of stay, and increased mortality. The need for prompt assessment and early intervention for infection is widely recognized by ED staff as best practice; however, the average length of time to antibiotic administration varies widely in published studies. An interdisciplinary quality improvement initiative including physician, nursing, and pharmacy leaders was created to streamline the identification and treatment for this high-risk population. Based on published evidence for best practice and national recognition of the need for rapid treatment, the goal was set for administration of antibiotic therapy to less than 60 minutes after ED arrival. This project was conducted at 2 emergency departments in a pediatric health care system with 520 beds and a level I and level II trauma designation. Approximately 154,000 patients are seen annually. In the emergency departments, 271 staff members, including registered nurses, paramedics, and patient care technicians, required education about using the newly designed process. Records from all patients with fever and a known history of pediatric cancer who presented to the emergency departments were included in the retrospective review, including patients with solid tumors, acute lymphoblastic leukemia, acute myeloid leukemia, and chronic myelogenous leukemia. Exclusion criteria included patients in known remission, those with prior antibiotic therapy at another facility, congenital neutropenia, or parental concern or objection to treatment. A retrospective medical record review of febrile oncology patients treated from September 2008 until May 2012 was conducted to evaluate the impact of this evidence-based practice change to streamline the "door to drug" process. The average length of time until antibiotic administration, nurses' compliance initiating

  14. Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol.

    PubMed

    Müller, Martin; Bartoszek, Gabriele; Beutner, Katrin; Klingshirn, Hanna; Saal, Susanne; Stephan, Anna-Janina; Strobl, Ralf; Grill, Eva; Meyer, Gabriele

    2015-01-01

    Hintergrund: Gelenkkontrakturen sind häufige Probleme gebrechlicher älterer Menschen in Pflegeheimen. Unabhängig von der genauen Anzahl an älteren Menschen, die an Gelenkkontrakturen leiden, scheint dieses Syndrom ein relevantes Problem im Setting Pflegeheim dazustellen. Durch einen zunehmenden Fokus auf Gelenkkontrakturen, z.B. durch die Pflegeversicherung, kam es zu einem Anstieg im Dokumentations- und Assessmentaufwand und in der Einführung von Präventionsmaßnahmen. Viel mehr Aufmerksamkeit sollte aber auf die tatsächliche Situation der älteren Menschen mit Gelenkkontrakturen in Pflegeheimen gelegt werden, vor allem deren tatsächlichen Einschränkungen in Aktivitäten und Teilhabe. Das Ziel dieser Studie ist daher, 1) die Entwicklung einer maßgeschneiderten Intervention zur Verbesserung der Funktionsfähigkeit, sozialen Teilhabe und Lebensqualität von Menschen mit Gelenkkontrakturen in Pflegeheimen und 2) die Überprüfung der Machbarkeit der Intervention, begleitet von einer Prozessevaluation.Methoden: Die Entwicklung der komplexen Intervention folgt dem UK Medical Research Council (MRC) Framework und integriert die Perspektiven aller potenziell relevanten Benutzergruppen von den betroffenen Personen über Kliniker und Forscher. Der Entwicklungsprozess beinhaltet einen systematischen Literaturreview, die Re-Analyse vorhandener Daten, Fokusgruppeninterviews mit Betroffenen, eine Expertentagung und eine Delphi-Studie mit klinischen Experten sowie eine Cluster-randomisierte Pilotstudie mit umfassender Prozessevaluation. Diskussion: Die geplante Studie wird eine maßgeschneiderte Intervention zur Verbesserung von Funktionsfähigkeit, sozialer Teilhabe und Lebensqualität von Menschen mit Gelenkkontrakturen in Pflegeheimen bereitstellen. Die Pilotstudie inklusive der Prozessevaluation stellt einen ersten Schritt zur Schätzung der Stärke des Interventionseffektes dar und wird weitere Studien vorbereiten.

  15. Nurse-Protocol Management of Low Back Pain

    PubMed Central

    Greenfield, Sheldon; Anderson, Hjalmar; Winickoff, Richard N.; Morgan, Annabelle; Komaroff, Anthony L.

    1975-01-01

    To test the validity of a nurse-administered protocol for low back pain, a prospective trial of 419 patients was undertaken in a walk-in clinic. In all, 222 patients were randomly allocated to a “nurse-protocol group” in which they were evaluated by one of five nurses using the protocol; the nurses independently managed 53 percent of the patients and referred to a physician patients with potentially complex conditions. In addition, 197 patients in a randomly allocated control group were managed by one of 32 physicians. Care in the experimental and control groups was compared by follow-up telephone contact and by a four-month chart review. There was no significant difference in symptomatic relief or the development of serious disease in the two groups. Nurse-protocol patients expressed greater satisfaction with the care they had received; patient satisfaction correlated positively with symptom relief. In over 95 percent of the patients, there were noncomplex, nonserious, nonchronic conditions as the cause of back pain. We conclude that nurse-protocol management of this generally benign condition in a primary care setting is both effective and efficient. PMID:128907

  16. Nursing protocol for telephonic supervision of clients.

    PubMed

    Martin, Elisabeth Moy; Coyle, Mary Kathleen

    2006-01-01

    Access to care, client vulnerabilities, technology, and health costs affect not only the delivery of health care but also the roles, responsibilities, and opportunities for nurses. Patients are often managed in the home or discharged from hospitals before they or their families are ready. To address some of these needs, nurses are utilizing telehealth opportunities. For many nurses, telehealth translates to telephonic nursing. This article provides an algorithm that nurses can utilize in order to safely monitor patients in their homes. This can be a cost-effective program, particularly for those who are homebound or for persons, such as the elderly or those with chronic illness, who have long-term needs that vary between relative health and acute illness. This algorithm serves as a guide in our nursing practice for the telephonic supervision of patients in the home environment.

  17. [Analysis of the nursing interventions performed by public health nurses in health centers using the NIC].

    PubMed

    Kim, Souk-Young; Chin, Young Ran; Oh, Vock-Chang; Park, Eun-Jun; Yun, Soon Nyoung; Lee, In Sook

    2006-04-01

    The purpose of this study was to identify nursing interventions performed by public health nurses in health centers. Data was collected by the taxonomy of Nursing Intervention Classification (NIC 3rd: 486 nursing interventions) from 131 public health nurses in health centers and analyzed using descriptive statistics. As its result, more than 50% of public health nurses performed 137 nursing interventions at least monthly. The most frequently used intervention class was "activity and exercise management", followed by "physical comfort promotion", "community health promotion", "life span care", "coping assistance", "self care facilitation", "information management", "nutrition support", "community risk management" and "patient education". One hundred twenty nursing interventions were rarely performed by 90% or more of the nurses. Most of them were in the physical complex domain. In conclusion, 137 interventions were performed by public health nurses at least monthly. NIC is helpful to build a standardized language for public health nursing.

  18. Intervention patterns of pivot nurses in oncology.

    PubMed

    Skrutkowski, Myriam; Saucier, Andréanne; Ritchie, Judith A; Tran, Ngoc; Smith, Kevin

    2011-01-01

    The Pivot Nurse in Oncology (PNO) is a health care professional dedicated to providing patients with cancer and their families with continuing and consistent supportive care throughout the care trajectory. The purpose of this paper is to describe the variation and frequency of nursing interventions delivered by 12 PNOs at our health centre. An administrative analysis over a three-year period revealed a total of 43,906 interventions that were grouped into 10 categories. This analysis provided a description of the intervention frequency and these interventions were further collapsed into the four role functions of the PNO. Coordination/continuity of care and the assessment of needs and symptoms were identified as the dominant practice domains of the PNO in the professional cancer navigator role.

  19. Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO) protocol: testing the effectiveness of a facilitation intervention in a pragmatic, cluster-randomised trial with an embedded process evaluation and cost analysis.

    PubMed

    Bucknall, Tracey K; Harvey, Gill; Considine, Julie; Mitchell, Imogen; Rycroft-Malone, Jo; Graham, Ian D; Mohebbi, Mohammadreza; Watts, Jennifer; Hutchinson, Alison M

    2017-07-11

    Vital signs are the primary indicator of physiological status and for determining the need for urgent clinical treatment. Yet, if physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, unplanned intensive care admissions, cardiac arrest and death may ensue. Although evidence demonstrates the benefit of early recognition and management of deteriorating patients, failure to escalate care and manage deteriorating patients remains a relatively frequent occurrence in hospitals. A pragmatic cluster-randomised controlled trial design will be used to measure clinical effectiveness and cost of a facilitation intervention to improve nurses' vital sign measurement, interpretation, treatment and escalation of care for patients with abnormal vital signs. A cost consequence analysis will evaluate the intervention cost and effectiveness, and a process evaluation will determine how the implementation of the intervention contributes to outcomes. We will compare clinical outcomes and costs from standard implementation of clinical practice guidelines (CPGs) to facilitated implementation of CPGs. The primary outcome will be adherence to the CPGs by nurses, as measured by escalation of care as per organisational policy. The study will be conducted in four Australian major metropolitan teaching hospitals. In each hospital, eight to ten wards will be randomly allocated to intervention and control groups. Control wards will receive standard implementation of CPGs, while intervention wards will receive standard CPG implementation plus facilitation, using facilitation methods and processes tailored to the ward context. The intervention will be administered to all nursing staff at the ward level for 6 months. At each hospital, two types of facilitators will be provided: a hospital-level facilitator as the lead; and two ward-level facilitators for each ward. This study uses an innovative, networked approach to facilitation to enable uptake of

  20. Nursing interventions in a telemonitoring program.

    PubMed

    Wakefield, Bonnie J; Scherubel, Melody; Ray, Annette; Holman, John E

    2013-03-01

    The use of telemonitoring of patients with chronic illness in their homes is growing. Current literature does not describe what types of patient problems are addressed by nurses in these programs and what actions are taken in response to identified problems. This study defined and analyzed patient problems and nursing actions delivered in a telemonitoring program focused on chronic disease management. Data were drawn from a clinical trial that evaluated telemonitoring in patients with comorbid diabetes and hypertension. Using study patient records, patient problems and nursing actions were coded using an inductive approach. In total, 2,336 actions were coded for 68 and 65 participants in two intervention groups. The most frequent reasons for contact were reporting information to the primary care provider and lifestyle information related to diabetes and hypertension (e.g., diet, smoking cessation, foot care, and social contacts). The most frequent mode of contact was the study sending a letter to a participant. Detailed descriptions of interventions delivered facilitate analysis of the unique contributions of nurses in the expanding market of telemonitoring, enable identification of the appropriate number and combination of interventions needed to improve outcomes, and make possible more systematic translation of findings to practice. Furthermore, this information can inform calculation of appropriate panel sizes for care managers and the competencies needed to provide this care.

  1. Mindfulness for Novice Pediatric Nurses: Smartphone Application Versus Traditional Intervention.

    PubMed

    Morrison Wylde, Chelsey; Mahrer, Nicole E; Meyer, Rika M L; Gold, Jeffrey I

    The current study compares the effects of a traditionally delivered mindfulness (TDM) intervention to a smartphone delivered mindfulness (SDM) intervention, Headspace, an audio-guided mindfulness meditation program, in a group of novice nurses. Novice nurses participating in a pediatric nurse residency program were asked to participate in either a TDM or SDM intervention. Participants (N=95) completed self-administered pencil and paper questionnaires measuring mindfulness skills, and risk and protective factors at the start of their residency and three months after entering the program. Nurses in the SDM group reported significantly more "acting with awareness" and marginally more "non-reactivity to inner experience" skills compared to the TDM group. The smartphone intervention group also showed marginally more compassion satisfaction and marginally less burnout. Additionally, nurses in the SDM group had lower risk for compassion fatigue compared to the TDM group, but only when the nurses had sub-clinical posttraumatic symptoms at the start of the residency training program. Smartphone delivered mindfulness interventions may provide more benefits for novice nurses than traditionally delivered mindfulness interventions. However, the smart-phone intervention may be better indicated for nurses without existing symptoms of posttraumatic stress. Mindfulness interventions delivered through smartphone applications show promise in equipping nurses with important coping skills to manage stress. Because of the accessibility of smartphone applications, more nurses can benefit from the intervention as compared to a therapist delivered intervention. However, nurses with existing stress symptoms may require alternate interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Improving patient adherence to lifestyle advice (IMPALA): a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol)

    PubMed Central

    Koelewijn-van Loon, Marije S; van Steenkiste, Ben; Ronda, Gaby; Wensing, Michel; Stoffers, Henri E; Elwyn, Glyn; Grol, Richard; van der Weijden, Trudy

    2008-01-01

    Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52 weeks. Clinical endpoints will

  3. Impact of a standardized nurse observation protocol including MEWS after Intensive Care Unit discharge.

    PubMed

    De Meester, K; Das, T; Hellemans, K; Verbrugghe, W; Jorens, P G; Verpooten, G A; Van Bogaert, P

    2013-02-01

    Analysis of in-hospital mortality after serious adverse events (SAE's) in our hospital showed the need for more frequent observation in medical and surgical wards. We hypothesized that the incidence of SAE's could be decreased by introducing a standard nurse observation protocol. To investigate the effect of a standard nurse observation protocol implementing the Modified Early Warning Score (MEWS) and a color graphic observation chart. Pre- and post-intervention study by analysis of patients records for a 5-day period after Intensive Care Unit (ICU) discharge to 14 medical and surgical wards before (n=530) and after (n=509) the intervention. For the total study population the mean Patient Observation Frequency Per Nursing Shift (POFPNS) during the 5-day period after ICU discharge increased from .9993 (95% C.I. .9637-1.0350) in the pre-intervention period to 1.0732 (95% C.I. 1.0362-1.1101) (p=.005) in the post-intervention period. There was an increased risk of a SAE in patients with MEWS 4 or higher in the present nursing shift (HR 8.25; 95% C.I. 2.88-23.62) and the previous nursing shift (HR 12.83;95% C.I. 4.45-36.99). There was an absolute risk reduction for SAE's within 120h after ICU discharge of 2.2% (95% C.I. -0.4-4.67%) from 5.7% to 3.5%. The intervention had a positive impact on the observation frequency. MEWS had a predictive value for SAE's in patients after ICU discharge. The drop in SAE's was substantial but did not reach statistical significance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Three nursing interventions' impact on HCAHPS scores.

    PubMed

    Kennedy, Bryan; Craig, Janet B; Wetsel, Margaret; Reimels, Elaine; Wright, Jennifer

    2013-01-01

    Staff on a 28-bed surgical unit in a suburban 461-bed medical center implemented 3 interventions to improve patient satisfaction. This quality improvement study investigated the effects of nurse manager rounding, postdischarge phone follow-up, and improved discharge teaching skills on patients' ratings of their care. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey scores demonstrated a steady upward trend over 18 months following implementation of the changes.

  5. Pediatric nurses' beliefs and pain management practices: an intervention pilot.

    PubMed

    Van Hulle Vincent, Catherine; Wilkie, Diana J; Wang, Edward

    2011-10-01

    We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses' management of children's pain. RCP is an interactive, content-focused, and Kolb's experiential learning theory-based intervention. Using a one-group, pretest-posttest design, we evaluated feasibility of RCP and pretest-posttest difference in scores for nurses' beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnaire (PBPQ, alpha=.83) before and after they completed the RCP and an Acceptability Scale afterward. Mean total PBPQ scores significantly improved from pretest to posttest as did simulated practice scores. After RCP in actual hospital practice, nurses administered significantly more ibuprofen and ketorolac and children's pain intensity significantly decreased. Findings showed strong evidence for the feasibility of RCP and study procedures and significant improvement in nurses' beliefs and pain management practices. The 2-hr RCP program is promising and warrants replication with an attention control group and a larger sample.

  6. [Smoking and diabetes. An intervention protocol].

    PubMed

    García Maeso, T; Cuevas Moreno, M J; Cantarero Lafuufente, L; Martínez Martínez, M I

    1998-06-01

    Tobacco smoking habit has been considered like an important cause of diabetes mellitus complications. Health education efficiency has been supported by many experiences in order to promote tobacco withdrawal by personal counselling with a direct nurse role at primary health care level. This study was carried out by all this information with tre straight goal of describing changes in the diabetic tobacco behaviour after a stepped counselling and a primary care nurse following. Description details are given of the smoking diabetic population counselled and listed at the same time in a nurse control clinic over a 18 months period. A Smokers Helping Scheme (SHS) was used. SHS understood that tobacco withdrawal is behavioural changing process with a few steps. Smokers were given with special written material for thes purpose. Results data were caught by the researchers from the chronical patient's census and from the tobacco program control sheets. Tobacco withdrawal was verified by espirated air CO determination (Smokorlizar system) and has been maintained by the 25% of managed diabetic people in this investigation. We strongly believe that nursing diabetic tobacco counselling by SHS acts like a behavioural modificator as results are showing. Health state improvement and a better life quality have been got on the diabetic people that has been managed.

  7. Evaluation of a Web-Based Tailored Nursing Intervention (TAVIE en m@rche) Aimed at Increasing Walking After an Acute Coronary Syndrome: A Multicenter Randomized Controlled Trial Protocol.

    PubMed

    Kayser, John William; Cossette, Sylvie; Côté, José; Bourbonnais, Anne; Purden, Margaret; Juneau, Martin; Tanguay, Jean-Francois; Simard, Marie-Josée; Dupuis, Jocelyn; Diodati, Jean G; Tremblay, Jean-Francois; Maheu-Cadotte, Marc-André; Cournoyer, Daniel

    2017-04-27

    Despite the health benefits of increasing physical activity in the secondary prevention of acute coronary syndrome (ACS), up to 60% of ACS patients are insufficiently active. Evidence supporting the effect of Web-based interventions on increasing physical activity outcomes in ACS patients is growing. However, randomized controlled trials (RCTs) using Web-based technologies that measured objective physical activity outcomes are sparse. Our aim is to evaluate in insufficiently active ACS patients, the effect of a fully automated, Web-based tailored nursing intervention (TAVIE en m@rche) on increasing steps per day. A parallel two-group multicenter RCT (target N=148) is being conducted in four major teaching hospitals in Montréal, Canada. An experimental group receiving the 4-week TAVIE en m@rche intervention plus a brief "booster" at 8 weeks, is compared with the control group receiving hyperlinks to publicly available websites. TAVIE en m@rche is based on the Strengths-Based Nursing Care orientation to nursing practice and the Self-Determination Theory of human motivation. The intervention is centered on videos of a nurse who delivers the content tailored to baseline levels of self-reported autonomous motivation, perceived competence, and walking behavior. Participants are recruited in hospital and are eligible if they report access to a computer and report less than recommended physical activity levels 6 months before hospitalization. Most outcome data are collected online at baseline, and 5 and 12 weeks postrandomization. The primary outcome is change in accelerometer-measured steps per day between randomization and 12 weeks. The secondary outcomes include change in steps per day between randomization and 5 weeks, and change in self-reported energy expenditure for walking and moderate to vigorous physical activity between randomization, and 5 and 12 weeks. Theoretical outcomes are the mediating role of self-reported perceived autonomy support, autonomous and

  8. Evaluation of a Web-Based Tailored Nursing Intervention (TAVIE en m@rche) Aimed at Increasing Walking After an Acute Coronary Syndrome: A Multicenter Randomized Controlled Trial Protocol

    PubMed Central

    Cossette, Sylvie; Côté, José; Bourbonnais, Anne; Purden, Margaret; Juneau, Martin; Tanguay, Jean-Francois; Simard, Marie-Josée; Dupuis, Jocelyn; Diodati, Jean G; Tremblay, Jean-Francois; Maheu-Cadotte, Marc-André; Cournoyer, Daniel

    2017-01-01

    Background Despite the health benefits of increasing physical activity in the secondary prevention of acute coronary syndrome (ACS), up to 60% of ACS patients are insufficiently active. Evidence supporting the effect of Web-based interventions on increasing physical activity outcomes in ACS patients is growing. However, randomized controlled trials (RCTs) using Web-based technologies that measured objective physical activity outcomes are sparse. Objective Our aim is to evaluate in insufficiently active ACS patients, the effect of a fully automated, Web-based tailored nursing intervention (TAVIE en m@rche) on increasing steps per day. Methods A parallel two-group multicenter RCT (target N=148) is being conducted in four major teaching hospitals in Montréal, Canada. An experimental group receiving the 4-week TAVIE en m@rche intervention plus a brief “booster” at 8 weeks, is compared with the control group receiving hyperlinks to publicly available websites. TAVIE en m@rche is based on the Strengths-Based Nursing Care orientation to nursing practice and the Self-Determination Theory of human motivation. The intervention is centered on videos of a nurse who delivers the content tailored to baseline levels of self-reported autonomous motivation, perceived competence, and walking behavior. Participants are recruited in hospital and are eligible if they report access to a computer and report less than recommended physical activity levels 6 months before hospitalization. Most outcome data are collected online at baseline, and 5 and 12 weeks postrandomization. The primary outcome is change in accelerometer-measured steps per day between randomization and 12 weeks. The secondary outcomes include change in steps per day between randomization and 5 weeks, and change in self-reported energy expenditure for walking and moderate to vigorous physical activity between randomization, and 5 and 12 weeks. Theoretical outcomes are the mediating role of self-reported perceived

  9. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention

    ERIC Educational Resources Information Center

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.

    2012-01-01

    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  10. A pilot randomised controlled trial of personalised care after treatment for prostate cancer (TOPCAT-P): nurse-led holistic-needs assessment and individualised psychoeducational intervention: study protocol

    PubMed Central

    Stanciu, Marian Andrei; Morris, Caroline; Makin, Matt; Watson, Eila; Bulger, Jenna; Evans, Richard; Hiscock, Julia; Hoare, Zoë; Edwards, Rhiannon Tudor; Neal, Richard David; Wilkinson, Clare

    2015-01-01

    Introduction Prostate cancer is common and the incidence is increasing, but more men are living longer after diagnosis, and die with their disease rather than of it. Nonetheless, specific and substantial physical, sexual, emotional and mental health problems often lead to a poor quality of life. Urology services increasingly struggle to cope with the demands of follow-up care, and primary care is likely to play the central role in long-term follow-up. The present phase II trial will evaluate the feasibility and acceptability of a nurse-led, person-centred psychoeducational intervention, delivered in community or primary care settings. Methods and analysis Prostate cancer survivors diagnosed in the past 9–48 months and currently biochemically stable will be identified from hospital records by their treating clinician. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Healthcare service use will be measured over 36 weeks. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation. Ethics and dissemination Ethics approval was granted by Bangor University and North Wales REC (13/WA/0291). Results will be reported in peer-reviewed publications, at scientific

  11. Physical therapy assessment and treatment protocol for nursing home residents.

    PubMed

    O'Neil, M B; Woodard, M; Sosa, V; Hunter, L; Mulrow, C D; Gerety, M B; Tuley, M

    1992-08-01

    This article describes a standard protocol for assessing physical function in elderly nursing home residents. Major physical dimensions that are measured with the protocol include range of motion, muscle force, muscle reflex activity, sensation, soft tissue status, balance/coordination, and posture. A practical, functionally prioritized treatment model based on the assessment is also presented. The standardized assessment and treatment plan may be useful to the physical therapist in (1) planning and prioritizing treatment, (2) identifying when goals have been met, (3) recognizing when there is a need for treatment plan modification, and (4) educating physical therapy students in applying problem-solving skills in their treatment sessions.

  12. Identification and Comparison of Interventions Performed by Korean School Nurses and U.S. School Nurses Using the Nursing Interventions Classification (NIC)

    ERIC Educational Resources Information Center

    Lee, Eunjoo; Park, Hyejin; Nam, Mihwa; Whyte, James

    2011-01-01

    The purpose of the study was to identify Nursing Interventions Classification (NIC) interventions performed by Korean school nurses. The Korean data were then compared to U.S. data from other studies in order to identify differences and similarities between Korean and U.S. school nurse practice. Of the 542 available NIC interventions, 180 were…

  13. Identification and Comparison of Interventions Performed by Korean School Nurses and U.S. School Nurses Using the Nursing Interventions Classification (NIC)

    ERIC Educational Resources Information Center

    Lee, Eunjoo; Park, Hyejin; Nam, Mihwa; Whyte, James

    2011-01-01

    The purpose of the study was to identify Nursing Interventions Classification (NIC) interventions performed by Korean school nurses. The Korean data were then compared to U.S. data from other studies in order to identify differences and similarities between Korean and U.S. school nurse practice. Of the 542 available NIC interventions, 180 were…

  14. Using the nursing interventions classification as a potential measure of nurse workload.

    PubMed

    de Cordova, Pamela B; Lucero, Robert J; Hyun, Sookyung; Quinlan, Patricia; Price, Kwanza; Stone, Patricia W

    2010-01-01

    Standardized terminologies, such as the Nursing Interventions Classification (NIC) taxonomy, may be used in multiple ways to represent nursing constructs. This study is the first known to explore the NIC as a framework for the development of a nursing workload measure. While the NIC may not represent the complexity of nurses' work, the classification system may represent uniformly the work of nurses in health information systems to yield reliable data for a nursing workload measure.

  15. Representation of Clinical Nursing Protocols Using GEM II & GEM Cutter.

    PubMed

    Koch, Karen A; Woodcock, Michael W; Harris, Marcelline R

    2010-11-13

    The machineable representation and execution of clinical guidelines has been the focus of research efforts for some time, however there is less examination of whether the methods and techniques for guidelines are sufficient for clinical protocols. The objective of this study was to test the feasibility of using the Guideline Elements Model II (GEM II) and GEM Cutter for the representation of clinical protocols, specifically clinical protocols commonly used by nurses. After downloading the GEM Cutter 2.5, we decomposed a set of clinical protocols and analyzed the completeness in which elemental protocol data was represented. One of the most complicated of these protocols (extravasations of infused medication) is presented as an example. While GEM II adequately represents core elements of clinical protocols at the high level, it was not possible to adequately represent sequence and associated role based permissions via use of conditional criteria at branching and procedural levels. Functionality of the tool would also be enhanced with more robust terminology management and support for multi-authoring.

  16. Nursing psychotherapeutic interventions: a review of clinical studies.

    PubMed

    Sampaio, Francisco Miguel Correia; Sequeira, Carlos Alberto da Cruz; Lluch Canut, María Teresa

    2015-08-01

    To summarise current knowledge about nursing psychotherapeutic interventions in adults. In Portugal, the provision of psychotherapeutic interventions is considered a competence of mental health nurses. However, literature is not totally clear about the differences between 'psychotherapy' and 'psychotherapeutic interventions' and about the specific characteristics that define a nursing psychotherapeutic intervention. Narrative review. A literature review utilising MEDLINE, PsycINFO, CINAHL, the Web of Science, Psychology and Behavioral Sciences Collection, and MedicLatina computerised databases for the period from 2003-2013. A total of 151 eligible articles were identified. Relevant data were extracted, and findings were synthetised in a narrative synthesis. Nursing psychotherapeutic interventions are frequently based on 'Cognitive-Behavioural' rationale. The usual length of these interventions varies between 5-16 weeks, in a total of 5-12 sessions of 45-60 minutes. The mechanisms of change are heterogeneous, but the therapeutic relationship between the nurse and the client seems to be the most important positive predictive factor of nursing psychotherapeutic interventions. Some of the most used outcome assessment measures include the Beck Depression Inventory, the Hospital Anxiety and Depression Scale, and the CORE-OM. The effectiveness of nursing psychotherapeutic interventions has been widely demonstrated in many studies. However, the need of further studies to prove its cost effectiveness is evident. It is necessary to have a better understanding of nursing psychotherapeutic interventions, one that explains its conceptual limits, to improve mental health nursing knowledge and create suitable models of psychotherapeutic intervention in nursing. The findings of this review can create awareness for some weaknesses of nursing knowledge about the psychotherapeutic intervention and for the need to produce knowledge, to nurture the nursing discipline in the area of

  17. Work complexity assessment, nursing interventions classification, and nursing outcomes classification: making connections.

    PubMed

    Scherb, Cindy A; Weydt, Alice P

    2009-01-01

    When nurses understand what interventions are needed to achieve desired patient outcomes, they can more easily define their practice. Work Complexity Assessment (WCA) is a process that helps nurses to identify interventions performed on a routine basis for their specific patient population. This article describes the WCA process and links it to the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC). WCA, NIC, and NOC are all tools that help nurses understand the work they do and the outcomes they achieve, and that thereby acknowledge and validate nursing's contribution to patient care.

  18. Representing public health nursing intervention concepts with HHCC and NIC.

    PubMed

    Lee, Nam-Ju; Bakken, Suzanne; Saba, Virginia

    2004-01-01

    It is imperative that public health nurses define their services and provide evidence supporting the effectiveness of interventions. The purpose of this paper is to examine the ex-tent to which two standardized nursing terminologies--Home Health Care Classification (HHCC) and Nursing Interventions Classification (NIC)--represent public health nursing practice according to core public health function in Public Health Nursing Intervention model. First, we divided all HHCC and NIC interventions into intervention focus levels: individual/family-focused, community-focused, and system-focused. Second, we categorized HHCC and NIC interventions according to core public health functions: assessment, policy development, and assurance and the categories of interventions in the PHI Model. We identified HHCC and NIC Nursing interventions that represented public health nursing concepts across core public health functions and categories of the PHI model. Analysis of the findings demonstrated that HHCC and NIC have terms for the concepts in the PHI model. Although HHCC and NIC cover many concepts in public health nursing practice, additional research is needed to extend these terminologies and to evaluate other standardized terminologies that can reflect more comprehensively public health nursing interventions.

  19. Pilot Testing of the NURSE Stress Management Intervention.

    PubMed

    Delaney, Colleen; Barrere, Cynthia; Robertson, Sue; Zahourek, Rothlyn; Diaz, Desiree; Lachapelle, Leeanne

    2016-12-01

    Student nurses experience significant stress during their education, which may contribute to illness and alterations in health, poor academic performance, and program attrition. The aim of this pilot study was to evaluate the feasibility and potential efficacy of an innovative stress management program in two baccalaureate nursing programs in Connecticut, named NURSE (Nurture nurse, Use resources, foster Resilience, Stress and Environment management), that assists nursing students to develop stress management plans. An explanatory sequential mixed-methods design was used to evaluate the effects of the intervention with 40 junior nursing students. Results from this study provide evidence that the NURSE intervention is highly feasible, and support further testing to examine the effect of the intervention in improving stress management in nursing students. © The Author(s) 2015.

  20. Nursing Care Plans Based on NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification: The Investigation of the Effectiveness of an Educational Intervention in Greece.

    PubMed

    Patiraki, Elisabeth; Katsaragakis, Stylianos; Dreliozi, Angeliki; Prezerakos, Panagiotis

    2017-04-01

    The aim of this study was to investigate the effectiveness of an educational intervention on home nursing care plans based on NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification for registered nurses working at primary healthcare settings in Greece. This is a quasi-experimental study without a control group. The sample consisted of 19 registered nurses. The study tool was a questionnaire administered pre- and post-educational intervention. The intervention improved their skills on nursing diagnoses' nomination, proper formulation, and individualization of defining characteristics, but it did not improve them in desired outcomes formulation. A significant effect of an educational intervention on nursing care plans was demonstrated. Nurses' knowledge and attitudes are important for understanding and integrating documentation within the nursing process. © 2015 NANDA International, Inc.

  1. PACE-UP (Pedometer and consultation evaluation - UP) – a pedometer-based walking intervention with and without practice nurse support in primary care patients aged 45–75 years: study protocol for a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Most adults do not achieve the 150 minutes weekly of at least moderate intensity activity recommended for health. Adults’ most common physical activity (PA) is walking, light intensity if strolling, moderate if brisker. Pedometers can increase walking; however, most trials have been short-term, have combined pedometer and support effects, and have not reported PA intensity. This trial will investigate whether pedometers, with or without nurse support, can help less active 45–75 year olds to increase their PA over 12 months. Methods/design Design: Primary care-based 3-arm randomized controlled trial with 12-month follow-up and health economic and qualitative evaluations. Participants: Less active 45–75 year olds (n = 993) will be recruited by post from six South West London general practices, maximum of two per household and households randomised into three groups. Step-count and time spent at different PA intensities will be assessed for 7 days at baseline, 3 and 12 months by accelerometer. Questionnaires and anthropometric assessments will be completed. Intervention: The pedometer-alone group will be posted a pedometer (Yamax Digi-Walker SW-200), handbook and diary detailing a 12-week pedometer-based walking programme, using targets from their baseline assessment. The pedometer-plus-support group will additionally receive three practice nurse PA consultations. The handbook, diary and consultations include behaviour change techniques (e.g., self-monitoring, goal-setting, relapse prevention planning). The control group will receive usual care. Outcomes: Changes in average daily step-count (primary outcome), time spent sedentary and in at least moderate intensity PA weekly at 12 months, measured by accelerometry. Other outcomes include change in body mass index, body fat, self-reported PA, quality of life, mood and adverse events. Cost-effectiveness will be assessed by the incremental cost of the intervention to the National Health Service

  2. PACE-UP (Pedometer and consultation evaluation--UP)--a pedometer-based walking intervention with and without practice nurse support in primary care patients aged 45-75 years: study protocol for a randomised controlled trial.

    PubMed

    Harris, Tess; Kerry, Sally M; Victor, Christina R; Shah, Sunil M; Iliffe, Steve; Ussher, Michael; Ekelund, Ulf; Fox-Rushby, Julia; Whincup, Peter; David, Lee; Brewin, Debbie; Ibison, Judith; DeWilde, Stephen; Limb, Elizabeth; Anokye, Nana; Furness, Cheryl; Howard, Emma; Dale, Rebecca; Cook, Derek G

    2013-12-05

    Most adults do not achieve the 150 minutes weekly of at least moderate intensity activity recommended for health. Adults' most common physical activity (PA) is walking, light intensity if strolling, moderate if brisker. Pedometers can increase walking; however, most trials have been short-term, have combined pedometer and support effects, and have not reported PA intensity. This trial will investigate whether pedometers, with or without nurse support, can help less active 45-75 year olds to increase their PA over 12 months. Primary care-based 3-arm randomized controlled trial with 12-month follow-up and health economic and qualitative evaluations. Less active 45-75 year olds (n = 993) will be recruited by post from six South West London general practices, maximum of two per household and households randomised into three groups. Step-count and time spent at different PA intensities will be assessed for 7 days at baseline, 3 and 12 months by accelerometer. Questionnaires and anthropometric assessments will be completed. The pedometer-alone group will be posted a pedometer (Yamax Digi-Walker SW-200), handbook and diary detailing a 12-week pedometer-based walking programme, using targets from their baseline assessment. The pedometer-plus-support group will additionally receive three practice nurse PA consultations. The handbook, diary and consultations include behaviour change techniques (e.g., self-monitoring, goal-setting, relapse prevention planning). The control group will receive usual care. Changes in average daily step-count (primary outcome), time spent sedentary and in at least moderate intensity PA weekly at 12 months, measured by accelerometry. Other outcomes include change in body mass index, body fat, self-reported PA, quality of life, mood and adverse events. Cost-effectiveness will be assessed by the incremental cost of the intervention to the National Health Service and incremental cost per change in step-count and per quality adjusted life year

  3. Pain management after cardiac surgery: experience with a nurse-driven pain protocol.

    PubMed

    van Valen, Richard; van Vuuren, Henriette; van Domburg, Ron T; van der Woerd, Dries; Hofland, Jan; Bogers, Ad J J C

    2012-03-01

    Management of post-operative pain is important for decreasing post-operative morbidity and mortality. After evaluating our pain score database of patients undergoing cardiac surgery (2007-2009) we revised our pain protocol. The new protocol allows nurses to administer analgesic medication without consulting the attending physician. The setting was a medium care unit, a nursing ward with additional monitoring of heart rate and rhythm. We investigated the effects of this revised pain protocol in a prospective consecutive cohort study. We evaluated 193 patients treated according to the revised protocol (RP group) during the first 72 hours post-cardiac surgery on the medium care unit. A visual analogue scale (VAS) was used as pain scoring system. These patients were compared with a control group (Ctrl group) consisting of 1535 patients. Patients from the RP group had a mean VAS of 2.2 compared to a mean VAS of 2.8 in the Ctrl group (p < 0.0001). In the Ctrl group 44% of patients with a VAS ≥ 4 maintained this score for 8 hours afterwards. In contrast, in the RP group 81% had a reduction in VAS score within 3 hours. Using the new protocol there were no adverse events requiring intervention such as medication or readmission to an intensive care unit. This study shows that in post-cardiac surgery patients a significant reduction in VAS scores can be safely realized by a nurse-driven protocol. Furthermore, a reduction in time to achieve an acceptable pain score (VAS < 4) was realized.

  4. Identifying nursing interventions associated with the accuracy used nursing diagnoses for patients with liver cirrhosis 1

    PubMed Central

    Gimenes, Fernanda Raphael Escobar; Motta, Ana Paula Gobbo; da Silva, Patrícia Costa dos Santos; Gobbo, Ana Flora Fogaça; Atila, Elisabeth; de Carvalho, Emilia Campos

    2017-01-01

    ABSTRACT Objective: to identify the nursing interventions associated with the most accurate and frequently used NANDA International, Inc. (NANDA-I) nursing diagnoses for patients with liver cirrhosis. Method: this is a descriptive, quantitative, cross-sectional study. Results: a total of 12 nursing diagnoses were evaluated, seven of which showed high accuracy (IVC ≥ 0.8); 70 interventions were identified and 23 (32.86%) were common to more than one diagnosis. Conclusion: in general, nurses often perform nursing interventions suggested in the NIC for the seven highly accurate nursing diagnoses identified in this study to care patients with liver cirrhosis. Accurate and valid nursing diagnoses guide the selection of appropriate interventions that nurses can perform to enhance patient safety and thus improve patient health outcomes.

  5. Translating an evidence-based protocol for nurse-to-nurse shift handoffs.

    PubMed

    Dufault, Marlene; Duquette, Cathy E; Ehmann, Jeanne; Hehl, Rose; Lavin, Mary; Martin, Valerie; Moore, Mary Ann; Sargent, Shirley; Stout, Patricia; Willey, Cynthia

    2010-06-01

    Ineffective communication is the most frequently reported cause of sentinel events in U.S. hospitals. Examining hospital processes and systems of communication, and standardizing communication practices can reduce the risks to patients in the acute care environment. The purpose of this paper is to describe the use of an innovative, translating-research-into-practice model to generate and test a cost-effective, easy to use, best-practice protocol for nurse-to-nurse shift handoffs in a medium-sized magnet-designated community hospital in the United States. Roger's Diffusion of Innovations Theory was used as the overall framework for the translational model with Orlando's theory providing theoretical evidence for the best practice protocol. Using the first three steps of the model, methods included: (1) identifying clinical problems related to shift handoffs; (2) appraising and systematically evaluating the strength of theoretical, empirical, and clinical evidence; and (3) translating this evidence into a best-practice patient-centered, standardized protocol for nurse-to-nurse shift handoffs. Meaningful clinician participation in the development of a standardized, evidence-based, patient-centered approach to nurses' change-of-shift handoffs was achieved. Using the Collaborative Research Utilization Model can facilitate the integration of new knowledge both in the clinical and academic community.

  6. Evaluation of a nurse mentoring intervention to family caregivers in the management of delirium after cardiac surgery (MENTOR_D): a study protocol for a randomized controlled pilot trial.

    PubMed

    Mailhot, Tanya; Cossette, Sylvie; Bourbonnais, Anne; Côté, José; Denault, André; Côté, Marie-Claude; Lamarche, Yoan; Guertin, Marie-Claude

    2014-07-30

    Despite the use of evidence-based preventive measures, delirium affects about 40% of patients following cardiac surgery with the potential for serious clinical complications and anxiety for caregivers. There is some evidence that family involvement as a core component of delirium management may be beneficial since familiarity helps patients stay in contact with reality, however, this merits further investigation. There is also currently a gap in the scientific literature regarding objective indicators that could enhance early detection and monitoring of delirium. Therefore, this randomized pilot trial examines the acceptability, feasibility, and preliminary efficacy of an experimental nursing intervention to help family caregivers manage post-cardiac surgery delirium in their relatives. It also explores the validity of a new and innovative measure that has potential as an indicator for delirium. In this two-group randomized pilot study (n = 30), the control group will receive usual care and the intervention group will receive the experimental intervention aimed at reducing delirium severity. The intervention nurse's objective will be to foster the family caregiver's self-efficacy in behaving in a supportive manner during delirium episodes. Data will be collected from standard delirium assessment scales and a novel measure of delirium, i.e., cerebral oximetry obtained using near infrared spectroscopy, as well as medical records and participants' responses to questionnaires. New strategies for early detection, monitoring, and management of delirium are needed in order to improve outcomes for both patients and families. The present article exposes feasibility issues based on the first few months of the empirical phase of the study that may be useful to the scientific community interested in improving the care of patients with delirium. Another potentially important contribution is in the exploration of cerebral oximetry, a promising measure as an objective

  7. Estimated Time to Complete Direct Nursing Interventions Using the Nursing Interventions Classification (NIC) at Eight Hospitals in South Korea.

    PubMed

    Lee, Eunjoo; Park, Hyejin

    2016-12-14

    Without data on the average time for performing nursing interventions, it is not possible to identify the cost-effective nursing practices, nurse staffing levels, and skill mix that are associated with improved patient outcomes, nor can reimbursement rates be accurately determined. The purpose of this study was to estimate the time needed to perform direct nursing interventions in Korea using the Nursing Interventions Classification (NIC) system, and then compare the findings with time estimates made by U.S. nurses. Data were collected from 721 registered nurses working in eight hospitals in South Korea. Each nurse was asked to choose the 30 most frequently used direct nursing interventions from a list of 433 from the Korean version of the NIC and to estimate the time needed to perform their selections. The U.S. data from the second edition of NIC were used for comparative purposes. Among the 92 nursing interventions studied, the majority were in the physiological domain, with 46 (50%) in Physiological: Basic and 25 (27%) in Physiological: Complex. In Korea, the intervention reported as taking the shortest time was Tube Care: Umbilical Line, while the intervention reported as taking the longest time was Bowel Irrigation. Comparisons of the time to perform interventions in the two countries indicated that only 38 (41.3%) interventions are performed in 15 min or less in both countries. Of the remainder, six interventions showed considerable variation in time to perform between the two countries. Findings from the study will provide fundamental data for calculating the cost of nursing interventions, which is critical for the establishment of reimbursement rates for interventions provided. © 2016 NANDA International, Inc.

  8. A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial.

    PubMed

    Black, Jeanne T; Romano, Patrick S; Sadeghi, Banafsheh; Auerbach, Andrew D; Ganiats, Theodore G; Greenfield, Sheldon; Kaplan, Sherrie H; Ong, Michael K

    2014-04-13

    Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic

  9. A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial

    PubMed Central

    2014-01-01

    Background Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. Methods/Design A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the ‘teach-back’ method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients’ physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. Discussion BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a

  10. Intervention Protocol for Investigating Yoga Implemented During Chemotherapy

    PubMed Central

    Sohl, Stephanie J.; Birdee, Gurjeet S.; Ridner, Sheila H.; Wheeler, Amy; Gilbert, Sandra; Tarantola, Danielle; Berlin, Jordan; Rothman, Russell. L.

    2016-01-01

    Objective Fatigue and other treatment-related symptoms are critical therapeutic targets for improving quality of life in patients with colorectal cancer during chemotherapy. Yoga is a promising intervention for improving these therapeutic targets and has been primarily investigated in the group-class format, which is less feasible for cancer patients with high symptom burden to attend. Thus, we developed a protocol for implementing yoga individually in the clinic among patients receiving chemotherapy. Methods We followed recommended domains for developing a yoga protocol to be used in an efficacy trial. These recommendations include consideration to the style, delivery, components of the intervention, dose, specific class sequences, facilitation of home practice, measurement of intervention fidelity, selection of instructors, and dealing with modifications. The intervention protocol was developed by an interdisciplinary team. Protocol Yoga Skills Training (YST) consists of four 30-minute in-person sessions implemented while in the chair during chemotherapy infusions for colorectal cancer with recommended daily home practice for eight weeks. Therapeutic goals of the YST are to reduce fatigue, circadian disruption, and psychological distress. Elements of the YST are awareness meditation, gentle seated movement, breathing practice, and relaxation meditation. Attention, comfort, and ease are also highlighted. Conclusion This description of a protocol for integrating yoga with conventional cancer treatment will inform future study designs and clinical practice. The design of the YST is novel because it implements yoga—most commonly studied when taught to groups outside of the clinical setting—individually during clinical care. PMID:27797662

  11. Crisis theory and intervention: a critical component of nursing education.

    PubMed

    Mariano, Carla

    2002-01-01

    Nurses deal daily with clients and families whose lives are in crisis, yet many feel educationally and professionally unprepared to intervene effectively in crisis situations. The author describes a course in Crisis Theory and Intervention offered to master's level nursing students. The importance of knowledge and skill in this area for practicing nurses and the need for incorporation of this content in nursing educational programs are discussed.

  12. Nursing Students' Experience of Bullying: Prevalence, Impact, and Interventions.

    PubMed

    Bowllan, Nancy Meierdierks

    2015-01-01

    Studies examining nursing students' unique experience of bullying are increasingly evident. This article explores national and international literature over the past decade on prevalence rates, potential impact on nursing students, and relevance to socialization to the profession of nursing. Historical considerations are provided along with policies and interventions to empower nursing leaders, academicians, clinicians, and students to prevent or minimize the destructive nature of bullying.

  13. A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

    PubMed

    Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

    2014-09-01

    To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

  14. Secondary insults related to nursing interventions in neurointensive care: a descriptive pilot study.

    PubMed

    Nyholm, Lena; Steffansson, Erika; Fröjd, Camilla; Enblad, Per

    2014-10-01

    The patients at a neurointensive care unit are frequently cared for in many ways, day and night. The aim of this study was to investigate the amount of secondary insults related to oral care, repositioning, endotracheal suctioning, hygienic measures, and simultaneous interventions at a neurointensive care unit with standardized care and maximum attention on avoiding secondary insults. The definition of a secondary insult was intracranial pressure > 20 mm Hg, cerebral perfusion pressure < 60 mm Hg and systolic blood pressure < 100 mm Hg for 5 minutes or more in a 10-minute period starting from when the nursing intervention began. The insult minutes did not have to be consecutive. The study included 18 patients, seven women and 11 men, aged 36-76 years with different neurosurgical diagnoses. The total number of nursing interventions analyzed was 1,717. The most common kind of secondary insults after a nursing measure was high intracranial pressure (n = 93) followed by low cerebral perfusion pressure (n = 43) and low systolic blood pressure (n = 14). Repositioning (n = 39) and simultaneous interventions (n = 32) were the nursing interventions causing most secondary insults. There were substantial variations between the patients; only one patient had no secondary insult. There were, overall, a limited number of secondary insults related to nursing interventions when a standardized management protocol system was applied to reduce the occurrence of secondary insults. Patients with an increased risk of secondary insults should be recognized, and their care and treatment should be carefully planned and performed to avoid secondary insults.

  15. The use of Nursing Interventions Classification (NIC) in identifying the workload of nursing: an integrative review.

    PubMed

    da Cruz, Carla Weidle Marques; Bonfim, Daiana; Gaidzinski, Raquel Rapone; Fugulin, Fernanda Maria Togeiro; Laus, Ana Maria

    2014-10-01

    To synthesize evidence related to the use of the Nursing Interventions Classification in order to identify nursing workload. An integrative literature review was conducted in June 2013. The search strategy yielded a total of 111 references, 18 of which were retrieved, read, and evaluated for relevance. A set of 10 articles met the selection criteria. A review of papers regarding the Nursing Interventions Classification and workload revealed the following themes: the identification of nursing interventions in areas of expertise and estimated times for their completion, the distribution of interventions in direct and indirect care, and the prevalence of the type of care in a given healthcare setting. © 2014 NANDA International, Inc.

  16. Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: a systematic review.

    PubMed

    Zhou, L; Liu, X-L; Tan, J-Y; Yu, H-P; Pratt, J; Peng, Y-Q

    2015-06-01

    Cancer pain management is still unsatisfactory, although some effective guidelines exist. Educational interventions are reported to be useful in pain relief for oncology outpatients. The aims of this systematic review were to evaluate the effects of nurse-led educational interventions on improving cancer pain outcomes for oncology patients, and to establish an effective cancer pain protocol for clinical nursing practice in China. A three-step search strategy was utilized. Eight databases were searched using the standards provided by the Joanna Briggs Institute that guided article selection, critical appraisal, data collection and data synthesis. A total of 1093 studies were identified through a literature search. Only six studies complied with the inclusion criteria and were found to be methodologically sound. In general, the included studies indicated positive results pertaining to patient's knowledge and attitudes towards analgesics and cancer pain management and decreased pain intensity. Studies reported minimal effects of intervention on anxiety, depression, satisfaction regarding cancer pain management and patient's quality of life. Educational interventions were reported as effective methods to improve cancer pain outcomes. Analysis of the six included studies demonstrated the overall positive effects of nurse-led educational interventions for improving cancer pain management. The results suggest that an effective cancer pain protocol for improving cancer pain management can be established in China. © 2015 International Council of Nurses.

  17. Identification and comparison of interventions performed by Korean school nurses and U.S. school nurses using the Nursing Interventions Classification (NIC).

    PubMed

    Lee, Eunjoo; Park, Hyejin; Nam, Mihwa; Whyte, James

    2011-04-01

    The purpose of the study was to identify Nursing Interventions Classification (NIC) interventions performed by Korean school nurses. The Korean data were then compared to U.S. data from other studies in order to identify differences and similarities between Korean and U.S. school nurse practice. Of the 542 available NIC interventions, 180 were selected as the basis of a questionnaire designed to quantify key aspects of school nursing practice. The data were collected from 131 school nurses working in Korea. The results indicated that Korean school nurses focused on classifications from the Physiological Basic domain. Comparisons to previously reported U.S. data reflect that U.S. school nurses focus primarily on the Behavioral domain. The data reflect important differences between the practice characteristics of Korean and U.S. school nurses. Further, the data support the utility of NICs in quantifying the practice characteristics of school nurses in Korea.

  18. Protocol of a multi-centre randomised controlled trial of a web-based information intervention with nurse-delivered telephone support for haematological cancer patients and their support persons.

    PubMed

    Bryant, Jamie; Sanson-Fisher, Rob; Stevenson, William; Smits, Rochelle; Henskens, Frans; Wei, Andrew; Tzelepis, Flora; D'Este, Catherine; Paul, Christine; Carey, Mariko

    2015-04-17

    High rates of anxiety, depression and unmet needs are evident amongst haematological cancer patients undergoing treatment and their Support Persons. Psychosocial distress may be minimised by ensuring that patients are sufficiently involved in decision making, provided with tailored information and adequate preparation for potentially threatening procedures. To date, there are no published studies evaluating interventions designed to reduce psychosocial distress and unmet needs specifically in patients with haematological cancers and their Support Persons. This study will examine whether access to a web-based information tool and nurse-delivered telephone support reduces depression, anxiety and unmet information needs for haematological cancer patients and their Support Persons. A non-blinded, parallel-group, multi-centre randomised controlled trial will be conducted to compare the effectiveness of a web-based information tool and nurse-delivered telephone support with usual care. Participants will be recruited from the haematology inpatient wards of five hospitals in New South Wales, Australia. Patients diagnosed with acute myeloid leukaemia, acute lymphoblastic leukaemia, Burkitt's lymphoma, Lymphoblastic lymphoma (B or T cell), or Diffuse Large B-Cell lymphoma and their Support Persons will be eligible to participate. Patients and their Support Persons will be randomised as dyads. Participants allocated to the intervention will receive access to a tailored web-based tool that provides accurate, up-to-date and personalised information about: cancer and its causes; treatment options including treatment procedures information; complementary and alternative medicine; and available support. Patients and Support Persons will complete self-report measures of anxiety, depression and unmet needs at 2, 4, 8 and 12 weeks post-recruitment. Patient and Support Person outcomes will be assessed independently. This study will assess whether providing information and support

  19. Development of a postgraduate interventional cardiac nursing curriculum.

    PubMed

    Currey, Judy; White, Kevin; Rolley, John; Oldland, Elizabeth; Driscoll, Andrea

    2015-11-01

    Interventional cardiology practices have advanced immensely in the last two decades, but the educational preparation of the workforce in cardiac catheter laboratories has not seen commensurate changes. Although on-the-job training has sufficed in the past, recognition of this workforce as a specialty practice domain now demands specialist educational preparation. The aim of this paper is to present the development of an interventional cardiac nursing curriculum nested within a Master of Nursing Practice in Australia. International and national health educational principles, teaching and learning theories and professional frameworks and philosophies are foundational to the program designed for interventional cardiac specialist nurses. These broader health, educational and professional underpinnings will be described to illustrate their application to the program's theoretical and clinical components. Situating interventional cardiac nursing within a Master's degree program at University provides nurses with the opportunities to develop high level critical thinking and problem solving knowledge and skills.

  20. A qualitative evaluation of a family nursing intervention.

    PubMed

    Duhamel, Fabie; Dupuis, France; Reidy, Mary; Nadon, Nathalie

    2007-01-01

    Congestive heart failure is a major source of anxiety for both patients and their family. This article presents the results of a qualitative case study aimed at evaluating family nursing interventions from the perspective of the family members and a clinical nurse specialist (CNS). A CNS applied a family nursing intervention program with 4 couples. Data were obtained through semistructured interviews preintervention and postintervention for the couples and postintervention for the CNS. The transcripts of the interviews were submitted for content analysis. For the couples, results show both spouses subject to a high level of suffering, which can be alleviated through a family nursing meeting that allows them to obtain a better understanding of each other's experience. For the CNS, family interventions were considered a privilege since they helped relieve suffering and her own feelings of powerlessness. These results have the potential to improve family nursing interventions and enhance CNS practice.

  1. A family nursing educational intervention supports nurses and families in an adult intensive care unit.

    PubMed

    Eggenberger, Sandra K; Sanders, Marita

    2016-11-01

    The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses' attitudes towards and confidence in providing family care, as well as families' perceptions of support from nurses in an adult critical care setting. An academic-clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members' experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic-clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in

  2. Paediatric intensive care nurses' and doctors' perceptions on nurse-led protocol-directed ventilation weaning and extubation.

    PubMed

    Tume, Lyvonne N; Scally, Alison; Carter, Bernie

    2014-11-01

    Nurse-led (protocol-directed) ventilation weaning (NLVW) is utilized in adult intensive care and has shown to be safe and reduce ventilation times. Our paediatric intensive care unit (PICU) implemented a NLVW (and extubation) protocol in 2004, yet it was observed that some NLVW-trained nurses were not undertaking the role in practice. To explore PICU nurses' and doctors' perceptions of and barriers to NLVW on a UK PICU, with the aim of facilitating more NLVW on our PICU by reducing these barriers. A cross-sectional electronic survey was used to collect data from both nurse ventilation weaners and all medical staff and advanced nurse practitioners (ANPs) on one PICU. Our survey response rates were 90% (36/40) nursing and 54% (20/37) medical. The four top reasons cited for nurses not being able to wean by protocol were not being allocated to a 'weanable' patient, being in an in-charge or runner role, high clinical workload and a perceived lack of support from medical staff/ANPs. The restrictive nature of our protocol also emerged as a key issue by all staff. The medical survey revealed an overwhelming positive response to NLVW with 90% believing that experienced PICU nurses should be allowed to wean ventilation. In contrast to the nurses perceived lack of support or encouragement for NLVW, medical staff rated their encouragement for the nurses to undertake this role as high. NLVW is a complex process, and factors that impair or facilitate this process relate not only to the weaning protocol itself, but also organizational processes and structural factors in a PICU. This paper highlights the complexities involved in instituting and establishing a nurse-led, protocol-driven ventilation weaning process within a PICU. Further, in depth research is required to examine both PICU nurses and doctors attitudes to NLVW both in the UK and across Europe. © 2013 British Association of Critical Care Nurses.

  3. Examining the Effects of a National League for Nursing Core Competencies Workshop as an Intervention to Improve Nurse Faculty Practice

    ERIC Educational Resources Information Center

    VanBever Wilson, Robin R.

    2010-01-01

    Due to the complex challenges facing schools of nursing, a research study was implemented to introduce nurse faculty at one small rural northeastern Tennessee school of nursing to the NLN "Core Competencies for Nurse Educators". Utilizing Kalb's Nurse Faculty Self-Evaluation Tool as a pre- and post-intervention test, 30 nurse faculty…

  4. Multifaceted ergonomic intervention programme for community nurses: pilot study.

    PubMed

    Szeto, Grace Pui Yuk; Law, Ka Yee; Lee, Edwin; Lau, Titanic; Chan, Shuk Ying; Law, Sheung-Wai

    2010-05-01

    This paper is a report of a pilot study conducted to investigate the effect of a tailor-made ergonomic intervention programme for community nurses. The nursing profession is known to be a high risk group for work-related musculoskeletal disorders. Community nurses are at risk as they have to travel to patients' homes and work in varied environments daily. Their occupational risk factors are unique and intervention strategies need to be specially designed to address these issues. The study was conducted from August 2007 to September 2008 in Hong Kong with community nurses from three hospitals. The intervention group (n = 14) received a multi-faceted ergonomic intervention programme over an 8-week period, with group training, onsite individual training, equipment modification, exercise programme, typing and computer workstation advice. The control group (n = 12) received no interventions. Both groups had baseline and follow-up assessments, which included musculoskeletal symptoms, perceived risk factors and functional outcome and physical mobility measures. The intervention group showed statistically significantly improved symptom scores and neck and upper limb functional outcomes at postintervention. The control group showed no change in symptom or functional outcomes. A multifaceted intervention programme may be more effective than interventions that mainly focus on ergonomic training and could be considered by community or home care nursing groups in other countries. The programme was based on risk assessment and may be a useful reference for other nursing groups in other countries.

  5. Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes

    PubMed Central

    Marelli, Giuseppe; Avanzini, Fausto; Iacuitti, Giuseppe; Planca, Enrico; Frigerio, Ilaria; Busi, Giovanna; Carlino, Liliana; Cortesi, Laura; Roncaglioni, Maria Carla; Riva, Emma

    2015-01-01

    Background. Hypoglycemia due to inadequate carbohydrate intake is a frequent complication of insulin treatment of diabetic in-patients. Objective. To assess the effectiveness of a nurse-managed protocol to prevent hypoglycemia during subcutaneous insulin treatment. Design. Prospective pre-post-intervention study. Methods. In 350 consecutive diabetic in-patients the incidence of hypoglycemia (blood glucose < 70 mg/dL) during subcutaneous insulin treatment was assessed before (phase A) and after (phase B) the protocol was adopted to permit (1) the patient to opt for substitutive food to integrate incomplete carbohydrate intake in the meal; (2) in case of lack of appetite or repeatedly partial intake of the planned food, prandial insulin administered at the end of the meal to be related to the actual amount of carbohydrates eaten; (3) intravenous infusion of glucose during prolonged fasting. Results. Eighty-four patients in phase A and 266 in phase B received subcutaneous insulin for median periods of, respectively, 7 (Q1–Q3 6–12) and 6 days (Q1–Q3 4–9). Hypoglycemic events declined significantly from 0.34 ± 0.33 per day in phase A to 0.19 ± 0.30 in phase B (P > 0.001). Conclusions. A nurse-managed protocol focusing on carbohydrate intake reduced the incidence of hypoglycemia in patients with diabetes receiving subcutaneous insulin in hospital. PMID:25961051

  6. Oncology nurses' use of nondrug pain interventions in practice.

    PubMed

    Kwekkeboom, Kristine L; Bumpus, Molly; Wanta, Britt; Serlin, Ronald C

    2008-01-01

    Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses.

  7. Effectiveness of INROADS into pain management, a nursing educational intervention.

    PubMed

    Salinas, Gregory D; Abdolrasulnia, Maziar

    2011-07-01

    Nurses play a critical role in managing a patient's pain, from initial evaluation to ongoing patient education. However, little information exists on current gaps in nurses' knowledge and their pain-related decision making. To this end, an educational intervention-the INROADS initiative-was designed to improve the knowledge of nurses involved in patient management as well as to guide them toward practices that are consistent with currently available evidence. The results from an evaluation of this intervention show that nurses participating in the INROADS program were 52% more likely to make evidence-based care choices for their patients, compared with a control group of demographically similar nurses. The effect of this program may reinforce it as a model for the design of future interventions for pain management. Copyright 2011, SLACK Incorporated.

  8. Reducing risk for ventilator associated pneumonia through nursing sensitive interventions.

    PubMed

    Micik, Svatka; Besic, Nihada; Johnson, Natalie; Han, Matilda; Hamlyn, Stephen; Ball, Hayley

    2013-10-01

    The purpose of this paper is to describe an improvement initiative designed to implement nurse sensitive interventions known to reduce patients' risk for ventilator associated pneumonia (VAP), in cardiothoracic intensive care patients. This initiative is a part of one Australian critical care unit's efforts to identify and measure compliance with key nursing interventions known to improve cardiac surgical patients' outcomes. The premise behind the initiative is that improved nursing process and surveillance systems allow emerging trends to catalyse action and motivate nurses to reduce patients' risk for infection acquisition. At five and nine months following implementation of the initiative a>70% compliance rate in 11 out of the 15 nurse sensitive interventions known to reduce patients' risks for VAP and a drop in VAP incidence from 13.4% to 7.69% from per 1000 ventilator days was accomplished.

  9. Palliative care nurses' spiritual caring interventions: a conceptual understanding.

    PubMed

    Ronaldson, Susan; Hayes, Lillian; Aggar, Christina; Green, Jennifer; Carey, Michele

    2017-04-02

    To investigate spiritual caring by palliative care nurses and to describe their interventions. Spirituality and spiritual caring are recognised as integral components of holistic nursing. Qualitative data captured on a questionnaire were analysed thematically ( Braun and Clarke, 2006 ). The study involved forty-two palliative care registered nurses working across seven palliative care services in Sydney, Australia. The research question was: 'What spiritual caring interventions do palliative care nurses use in their practice?' Nurses completed an open-ended questionnaire to identify and interpret their spiritual caring. Three sub-theme categories and four major concepts of spiritual caring. Categories identified are: humanistic, pragmatic and religious interventions; while concepts of spiritual caring are: 'being with', 'listening to', 'facilitation of' and 'engaging in'. A conceptual understanding of spiritual caring was identified.

  10. Implementation of efficacy enhancement nursing interventions with cardiac elders.

    PubMed

    Hiltunen, Elizabeth F; Winder, Patricia A; Rait, Michelle A; Buselli, Elizabeth F; Carroll, Diane L; Rankin, Sally H

    2005-01-01

    Intervention strategies based on social cognitive theory and encompassing the bio-psycho-behavioral domains are proposed to enhance self-efficacy in men and women 65 years and older recovering from myocardial infarction and coronary artery bypass grafting. This paper describes a study in which the theory-based development of efficacy enhancement (EE) nursing interventions and their implementation and utilization with interventions from the Nursing Interventions Classification (NIC) were used with cardiac elders in the treatment group of the community-based randomized clinical, trial, "Improving Health Outcomes in Unpartnered Cardiac Elders." Advanced practice nurses (APNs) provided the nursing intervention to 110 participants (mean age = 76.2, SD = 6.0) for the first 12 weeks after discharge to home. After an initial introductory meeting in the acute-care setting, participant contacts by the APNs were made at a home visit and telephone calls at 2, 6, and 10 weeks. Results describe the number of participants receiving interventions at all contacts over 12 weeks, at specified contact points, and the intensity (nurse time) of the interventions. Verbal encouragement and mastery were EE interventions used with the greatest number of participants. Exercise promotion, energy management and active listening were NIC interventions used with the most participants. Variations in the use of interventions over 12 weeks and their intensities, suggest patterns of recovery in the elders. During rehabilitation EE interventions can be successfully implemented with men and women 65 years and older and individualized to the recovery trajectory. Nurses can integrate specific EE interventions with more general interventions from the bio-psycho-behavioral domains to enhance the recovery process for cardiac elders.

  11. The Experience of Intense Pain: Nursing Management and Interventions.

    PubMed

    Kiser-Larson, Norma

    Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.

  12. Elementary School Nurse Interventions: Attendance and Health Outcomes

    ERIC Educational Resources Information Center

    Weismuller, Penny C.; Grasska, Merry A.; Alexander, Marilyn; White, Catherine G.; Kramer, Pat

    2007-01-01

    Regular school attendance is a necessary part of the learning process; student absenteeism has a direct association with poor academic performance. School nurses can influence student attendance. This study describes the impact of school nurse interventions on student absenteeism and student health. A retrospective review of 240 randomly selected…

  13. Effects of nurses' practice of a sedation protocol on sedation and consciousness levels of patients on mechanical ventilation.

    PubMed

    Abdar, Mohammad Esmaeili; Rafiei, Hossein; Abbaszade, Abbas; Hosseinrezaei, Hakimeh; Abdar, Zahra Esmaeili; Delaram, Masoumeh; Ahmadinejad, Mehdi

    2013-09-01

    Providing high-quality care in the intensive care units (ICUs) is a major goal of every medical system. Nurses play a crucial role in achieving this goal. One of the most important responsibilities of nurses is sedation and pain control of patients. The present study tried to assess the effect of nurses' practice of a sedation protocol on sedation and consciousness levels and the doses of sedatives and analgesics in the ICU patients. This clinical trial was conducted on 132 ICU patients on mechanical ventilation. The patients were randomly allocated to two groups. While the control group received the ICU's routine care, the intervention group was sedated by ICU nurses based on Jacob's modified sedation protocol. The subjects' sedation and consciousness levels were evaluated by the Richmond Agitation Sedation Scale (RASS) and the Glasgow Coma Scale (GCS), respectively. Doses of administered midazolam and morphine were also recorded. The mean RASS score of the intervention group was closer to the ideal range (-1 to +1), compared to the control group (-0.95 ± 0.3 vs. -1.88 ± 0.4). Consciousness level of the control group was lower than that of the intervention group (8.4 ± 0.4 vs. 8.8 ± 0.4). Finally, higher doses of midazolam and morphine were administered in the control group than in the intervention group. As nurses are in constant contact with the ICU patients, their practice of a sedation protocol can result in better sedation and pain control in the patients and reduce the administered doses of sedatives and analgesics.

  14. Development of Detailed Clinical Models for Nursing Assessments and Nursing Interventions

    PubMed Central

    Park, Hyeoun-Ae; Kim, Younglan; Lee, Myung Kyung; Lee, Youngji

    2011-01-01

    Objectives The aim of this study was to develop and validate Detailed Clinical Models (DCMs) for nursing assessments and interventions. Methods First, we identified the nursing assessment and nursing intervention entities. Second, we identified the attributes and the attribute values in order to describe the entities in more detail. The data type and optionality of the attributes were then defined. Third, the entities, attributes and value sets in the DCMs were mapped to the International Classification for Nursing Practice Version 2 concepts. Finally, the DCMs were validated by domain experts and applied to case reports. Results In total 481 DCMs, 429 DCMs for nursing assessments and 52 DCMs for nursing interventions, were developed and validated. The DCMs developed in this study were found to be sufficiently comprehensive in representing the clinical concepts of nursing assessments and interventions. Conclusions The DCMs developed in this study can be used in electronic nursing records. These DCMs can be used to ensure the semantic interoperability of the nursing information documented in electronic nursing records. PMID:22259726

  15. [Nursing practice within the French national gendarmerie intervention group].

    PubMed

    Fressancourt, Yves; Quémeneur, Éric; Bertho, Kilian; Dubourg, Olivier

    2016-11-01

    Intervening in the event of a major crisis in France and abroad, the national gendarmerie intervention group carries out complex and specific operations in varied conditions and environments. Due to the multiplicity and dangerousness of the missions, adapted and integrated medical support is essential. In this context, nurses provide operational medical assistance as close as possible to the intervention. This nursing practice in an exceptional environment requires specific knowledge and intensive training.

  16. A motivational interviewing education intervention for home healthcare nurses.

    PubMed

    Pyle, Joni J

    2015-02-01

    The ability of registered nurses to communicate well with their patients is foundational to patient-centered care, the management of chronic illness, and general healthcare. It is also vital to the nurse-patient relationship. Nurses, however, tend to identify with their patients' physical needs and rely heavily on the technical skills with which they feel more comfortable. This lack of ability to communicate well with their patients can result in poor nurse-patient understanding, can lead to poor patient outcomes, and a lack of patient engagement and involvement in their care. Motivational interviewing (MI), a patient-centered manner of communication, is a means to direct the nurse-patient interaction in a way that is patient centered. Brief education of MI has shown to be effective in increasing the self-efficacy of nurses in their ability to communicate well with their patients. In 2 geographically diverse Pennsylvania home care settings, MI education was provided to 20 nurses. The educational intervention was designed to increase the self-efficacy of nurses regarding their ability to affect the negative behaviors of chronically ill patients. A pretest and posttest was administered to the nurse participants to determine the effectiveness of the educational intervention. This evidence-based education increased the nurses' overall communication self-efficacy by 25%.

  17. Validation by school nurses of the Nursing Intervention Classification for computer software.

    PubMed

    Redes, S; Lunney, M

    1997-01-01

    Validation of standardized nursing language for use by specialty nurses is important for the design of computer software. The purposes of this study were to validate the usefulness of the 433 interventions in the Nursing Intervention Classification (NIC) for school nurses and to identify interventions that could be omitted from computer software for school nurses. A school nursing listserv, SCHLRN-L, was used to recruit volunteers. Ninety-three volunteers from the listserv also recruited 26 school nurses who were not members of the listserv. The total sample was 102 school nurses from 25 states and other areas, 76 listserv volunteers, and 26 others. E-mail was used to send and receive the survey forms to portions of the sample. A majority of interventions (n = 241; 56%) were selected as used by more than 50% of the sample. Of these, 53 direct care interventions were selected as used by more than 80% of the sample. Fifty interventions were not used by 100% of the sample. E-mail was a useful means to obtain a national sample and collect data.

  18. Interventions to manage compassion fatigue in oncology nursing.

    PubMed

    Aycock, Nancy; Boyle, Deborah

    2009-04-01

    Work-related stress emanating from close interpersonal contact with patients with cancer and their families may result in physical, emotional, social, and spiritual adversity for oncology nurses. The negative result of this cumulative distress has historically been referred to as burnout. However, this dated term does not truly depict the result of the longitudinal workplace ramifications of sadness and despair on nursing staff. This article proposes that the phrase compassion fatigue replace the outdated notion of burnout in describing this phenomenon. Although not clearly and uniformly described in the literature, this occurrence is seen regularly in clinical practice and is conceptually known by nurses. Limited information is available about interventions to manage compassion fatigue; therefore, a national survey was conducted to identify resources available to oncology nurses to counter this phenomenon. Participants provided information about the availability of interventions in three major categories: on-site professional resources, educational programs, and specialized retreats. The availability of resources ranged from 0%-60%. Survey findings, along with narrative comments by respondents, provide relevant information for oncology nurses and their employers. By recognizing the perils of inattention to this frequent nursing phenomenon and the scope of existing workplace options that may augment nurse coping, oncology nurses' recognition and management of this entity may be enhanced. Organizations also may be encouraged to periodically inventory their support and lobby for workplace interventions to manage this critical work-related issue.

  19. Telehealth interventions to improve clinical nursing of elders.

    PubMed

    Jones, Josette F; Brennan, Patricia Flatley

    2002-01-01

    This chapter reviews reports of research conducted worldwide from 1966 to January 2001 on telehealth interventions in clinical nursing for elders. Reports were identified through a systematic search of MEDLINE, CINAHL, PsychInfo, ERIC, and ACM using the search terms Telemedicine or Health Information Networks, Nursing, and Research, and were restricted to those published in English. Reports of research using interactive computer technology to assess or intervene with nursing problems commonly observed in persons age 65 and older were sought. Only published reports presenting the findings of an exploratory or experimental study and exploring the association between one intervention variable and technology were included. The search resulted in 18 research reports describing eight research projects. Due to the preponderance of demonstrations and feasibility reports, the dearth of experimental investigations, and the heterogeneous nature of the few studies identified, statistical summarization was not attempted. Telehealth interventions have the potential to improve the clinical nursing care of elders because they provide alternative, equivalent approaches to assess key indicators of the physical and psychological state of elders; are acceptable to nurses, elders, and family caregivers; and may prove less costly than face-to-face interventions. Telehealth approaches provide not only acceptable substitutes for discrete nursing actions but also can serve as a context within which a large range of professional gerontological nursing services can be delivered in a manner that is timely and convenient for elders.

  20. An intervention aimed at reducing plagiarism in undergraduate nursing students.

    PubMed

    Smedley, Alison; Crawford, Tonia; Cloete, Linda

    2015-05-01

    Plagiarism is a current and developing problem in the tertiary education sector where students access information and reproduce it as their own. It is identified as occurring in many tertiary level degrees including nursing and allied health profession degrees. Nursing specifically, is a profession where standards and ethics are required and honesty is paramount. The aim of this study was to evaluate the change in nursing student's knowledge and understanding of plagiarism before and after an educational intervention in their first semester of the Bachelor of nursing degree at a private college of higher education in Sydney, Australia. This study concluded that an educational intervention can increase knowledge and awareness of plagiarism among nursing students. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Nursing on empty: compassion fatigue signs, symptoms, and system interventions.

    PubMed

    Harris, Chelsia; Griffin, Mary T Quinn

    2015-01-01

    Few healthcare organizations acknowledge, discuss, or provide interventions for assisting with compassion fatigue. Yet, it is an important concept due to its individual, professional, and financial costs. This article defines compassion fatigue, differentiates it from burnout, and offers system interventions for supporting nurses and reducing compassion fatigue.

  2. Effect of an oral healthcare protocol in nursing homes on care staffs' knowledge and attitude towards oral health care: a cluster-randomised controlled trial.

    PubMed

    Janssens, Barbara; De Visschere, Luc; van der Putten, Gert-Jan; de Lugt-Lustig, Kersti; Schols, Jos M G A; Vanobbergen, Jacques

    2016-06-01

    To explore the impact of a supervised implementation of an oral healthcare protocol, in addition to education, on nurses' and nurses' aides' oral health-related knowledge and attitude. A random sample of 12 nursing homes, accommodating a total of 120-150 residents, was obtained using stratified cluster sampling with replacement. The intervention included the implementation of an oral healthcare protocol and three different educational stages. One of the investigators supervised the implementation process, supported by a dental hygienist. A 34-item questionnaire was developed and validated to evaluate the knowledge and attitude of nurses and nurses' aides at baseline and 6 months after the start of the intervention. Linear mixed-model analyses were performed to explore differences in knowledge and attitude at 6 months after implementation. At baseline, no significant differences were observed between the intervention and the control group for both knowledge (p = 0.42) and attitude (p = 0.37). Six months after the start of the intervention, significant differences were found between the intervention and the control group for the variable knowledge in favour of the intervention group (p < 0.0001) but not for the variable attitude (p = 0.78). Out of the mixed model with attitude as the dependent variable, it can be concluded that age (p = 0.031), educational level (p = 0.009) and ward type (p = 0.014) have a significant effect. The mixed model with knowledge as the dependent variable resulted in a significant effect of the intervention (p = 0.001) and the educational level (p = 0.009). The supervised implementation of an oral healthcare protocol significantly increased the knowledge of nurses and nurses' aides. In contrast, no significant improvements could be demonstrated in attitude. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  3. Clinical management of DIC: early nursing interventions.

    PubMed

    Epstein, C; Bakanauskas, A

    1991-01-01

    Achievement of successful patient outcomes depends on the availability of a primary nurse responsible for all aspects of nursing care. A consistent caregiver not only has a grasp of phenomena at hand but possesses an overall perspective of recovery. Care can be evaluated and readjusted on a timely basis. Identification of signs of progress as well as deterioration may be facilitated through continuity of care. The primary nurse can provide meaningful, ongoing information to the patient and significant others as a means of optimizing their coping behaviors. Effective nursing care of the patient with DIC is enhanced by a thorough understanding of its pathophysiology and its clinical manifestations. When the critical care nurse has a comprehensive knowledge base and uses purposeful assessment skills, potential complications become much clearer and are avoided. The primary nurse who knows how to prioritize care is capable of anticipating the patient's needs. By integrating theory with practice, the critical care nurse functions from a position of strength in promoting quality patient care.

  4. [Protocol of nursing care to traumatized patients in the aerospace environment: care before flight].

    PubMed

    Schweitzer, Gabriela; do Nascimento, Eliane Regina Pereira; Moreira, André Ricardo; Bertoncello, Kátia Cilene Godinho

    2011-01-01

    The study aimed to present a protocol for nursing care in pre aerospace removing of adult victims of trauma. A qualitative convergent care research was performed at the Division of Air Operations in the municipality of San Jose-SC, Brazil, from April to June 2010. The study was based on the principles of the Pre-hospital Trauma Life Support. Individual interviews and group meetings were used. Eight nurses participated in the service. The proposed protocol includes safety boarding, disembarking, assessment of the scene, primary assessment, secondary assessment and stabilization of the patient. The protocol will provide a safer nursing practice care to patients aero removed.

  5. Spiritual care activities of nurses using Nursing Interventions Classification (NIC) labels.

    PubMed

    Cavendish, Roberta; Konecny, Lynda; Mitzeliotis, Claudia; Russo, Donna; Luise, Barbara; Lanza, Melissa; Medefindt, Judith; Bajo, Mary Ann McPartlan

    2003-01-01

    To describe the spiritual care activities of nurses as subsequently identified in the Nursing Interventions Classification (NIC) labels. Data were taken from a larger study that used a multiple triangulation research design to describe spiritual perspectives, interventions, and attitudes of 1,000 Sigma Theta Tau International members. Data analysis included descriptive and multivariate statistics for quantitative items, and content analysis for responses to questions. 97 respondents reported providing 32 spiritual care activities. Ten NIC labels actually mapped the nurses' spiritual care activities. Spiritual care activities involve a broad spectrum of interventions that may be unique to each patient. The 32 spiritual care activities described by the nurses provide new knowledge regarding core spiritual care activities. The use of NIC labels can facilitate documentation of spiritual care activities in diverse practice settings. This study supports greater specificity in describing spiritual care interventions to a level that allows replication and advancement of knowledge.

  6. Interventions for compassionate nursing care: A systematic review.

    PubMed

    Blomberg, Karin; Griffiths, Peter; Wengström, Yvonne; May, Carl; Bridges, Jackie

    2016-10-01

    Compassion has been identified as an essential element of nursing and is increasingly under public scrutiny in the context of demands for high quality health care. While primary research on effectiveness of interventions to support compassionate nursing care has been reported, no rigorous critical overview exists. To systematically identify, describe and analyse research studies that evaluate interventions for compassionate nursing care; assess the descriptions of the interventions for compassionate care, including design and delivery of the intervention and theoretical framework; and to evaluate evidence for the effectiveness of interventions. Published international literature written in English up to June 2015 was identified from CINAHL, Medline and Cochrane Library databases. Primary research studies comparing outcomes of interventions to promote compassionate nursing care with a control condition were included. Studies were graded according to relative strength of methods and quality of description of intervention. Narrative description and analysis was undertaken supported by tabulation of key study data including study design, outcomes, intervention type and results. 25 interventions reported in 24 studies were included in the review. Intervention types included staff training (n=10), care model (n=9) and staff support (n=6). Intervention description was generally weak, especially in relation to describing participants and facilitators, and the proposed mechanisms for change were often unclear. Most interventions were associated with improvements in patient-based, nurse-based and/or quality of care outcomes. However, overall methodological quality was low with most studies (n=16) conducted as uncontrolled before and after studies. The few higher quality studies were less likely to report positive results. No interventions were tested more than once. None of the studies reviewed reported intervention description in sufficient detail or presented sufficiently

  7. Nursing interventions on sexual health: validation of the NISH Scale in baccalaureate nursing students in Taiwan.

    PubMed

    Huang, Cheng-Yi; Tsai, Li-Ya; Liao, Wen-Chun; Lee, Sheuan

    2012-10-01

    No widely accepted tool is available to assess nursing interventions on patient's sexual health among nursing students. Consequently, nursing school faculty cannot determine the sexual healthcare-related skills of nursing students. The aim of this article was to develop and test a scale to assess nursing interventions on sexual health. A 19-item instrument Nursing Interventions on Sexual Health (NISH) was developed using 10 semi-structured interviews of senior nursing students, expert review, and comparative analysis of text and field notes. A total of 198 senior nursing students were recruited from two nursing schools in central Taiwan to test the instrument. Exploratory factor analysis (EFA) was used to measure construct validity and Cronbach's alpha to measure internal consistency. Validity and reliability of the NISH scale based on the Permission, Limited Information, Specific Suggestion, and Intensive Therapy (PLISSIT) model. Three factors (permission, limited information, and specific suggestion) were retained after EFA of the 19 items of NISH. Cronbach's alpha for the subscales increased from 0.71-0.93 to 0.74-0.94 and from 0.93 to 0.95 for the total scale, with 72.42% of the cumulative variance explained by these three factors. Nursing students' age (P=0.019) correlated positively with total score. NISH is a useful and reliable scale for assessing the frequency of PLISSIT-related behaviors used by nursing students to address patient's sexual health concerns. Nursing faculties can use this scale to assess students' performance and find their omitted behaviors in clinical practice regarding sexual health care. © 2012 International Society for Sexual Medicine.

  8. Standardising analgesic administration for nurses: a prospective intervention study.

    PubMed

    Schiek, Susanne; Moritz, Katharina; Seichter, Stefanie J; Ghanem, Mohamed; von Salis-Soglio, Georg; Frontini, Roberto; Bertsche, Thilo

    2016-12-01

    Background Uncontrolled pain reduces quality of life, delays recovery from surgery and can potentially contribute to the development of chronic pain. Strategies to improve pain management are desirable in view of these detrimental outcomes, yet frequently they are predominately medically based despite nurses playing key roles in pain assessment and analgesic administration. Objective To develop an algorithm-based guidance addressing nurses' pain assessment and analgesic administration and investigating its impact on quality of pain management. Setting Two orthopaedic units in a university hospital. Method An interdisciplinary expert panel consisting of physicians, nurses and clinical pharmacists developed an algorithm-based guidance in analgesic administration for nurses. The guidance was based on current guidelines addressing the appropriate use of analgesics. In a prospective intervention study, clinical pharmacists acted as independent monitors who assessed nurses' pain assessment and analgesic administration before (control period: usual care without any further support) and after implementation of the algorithm-based guidance (intervention period). We evaluated patient-nurse contacts for guideline adherence. We predefined guideline adherence (main outcome) as fulfilling all three of the following criteria: (A) nurses' pain intensity assessment, (B) their assessment of the patients' need for analgesics, and (C) analgesic administration depending on patients' individual pain intensity (including choice of prescribed analgesics). Main outcome measure Adherence to pain management guidelines. Results We analysed 706 patient-nurse contacts with 162 patients in the control and 748 contacts with 168 patients in the intervention period. Without support, guidelines were followed in 6 % of the patient contacts. We achieved an increase to 54 % (p < 0.001) after guidance implementation (main outcome). Guideline adherence decreased with rising pain intensity (slope

  9. Interventions Used by Nurse Preceptors to Develop Critical Thinking of New Graduate Nurses: A Systematic Review.

    PubMed

    Schuelke, Sue; Barnason, Susan

    Healthcare complexity and patient acuity necessitate competent nurses with critical thinking abilities. However, these skill sets are less developed among newly hired graduate nurses. The overall purpose of this systematic review was to examine interventions/strategies implemented by preceptors in healthcare organizations to promote critical thinking of new graduate nurses. A systematic search of the literature resulted in 602 citations, with nine studies meeting the inclusion criteria. Educational interventions were varied and will be described in this article. Preceptor education was a key component in the studies reviewed.

  10. An exploration of factors influencing ambulance and emergency nurses' protocol adherence in the Netherlands.

    PubMed

    Ebben, Remco H A; Vloet, Lilian C M; Schalk, Donna M J; Mintjes-de Groot, Joke A J; van Achterberg, Theo

    2014-03-01

    Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses' adherence to protocols. Semi-structured interviews were held with ambulance nurses, emergency nurses, and physicians (N = 20) with medical end responsibility in the Netherlands to explore influencing factors. Content analysis was used to identify influencing factors. The main influencing factors for adherence were individual factors, including individual (clinical) experience, awareness, and the preference of following local protocols instead of national protocols. Organizational or external factors were involvement in protocol development, training and education, control mechanisms for adherence, and physicians' interest. Also of influence were protocol characteristics including integration of the advanced trauma life support approach, being in accordance with daily practice, and the generality of the content. Influencing factors could be a barrier as well as a facilitator for adherence. Factors influencing ambulance and emergency nurses' protocol adherence could be assigned to individual, organizational, and external categories, as well as to protocol characteristics. To improve adherence, implementation strategies should be tailored to identified factors. Multifaceted implementation strategies will be needed to improve adherence. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  11. Worksite Physical Activity Intervention for Ambulatory Clinic Nursing Staff.

    PubMed

    Tucker, Sharon; Farrington, Michele; Lanningham-Foster, Lorraine M; Clark, M Kathleen; Dawson, Cindy; Quinn, Geralyn J; Laffoon, Trudy; Perkhounkova, Yelena

    2016-07-01

    Health behaviors, including physical activity (PA), of registered nurses (RNs) and medical assistants (MAs) are suboptimal but may improve with worksite programs. Using a repeated-measures crossover design, the authors explored if integrating a 6-month worksite non-exercise activity thermogenesis (NEAT) intervention, with and without personalized health coaching via text messaging into workflow could positively affect sedentary time, PA, and body composition of nursing staff without jeopardizing work productivity. Two ambulatory clinics were randomly assigned to an environmental NEAT intervention plus a mobile text message coaching for either the first 3 months (early texting group, n = 27) or the last 3 months (delayed texting group, n = 13), with baseline 3-month and 6-month measurements. Sedentary and PA levels, fat mass, and weight improved for both groups, significantly only for the early text group. Productivity did not decline for either group. This worksite intervention is feasible and may benefit nursing staff. © 2016 The Author(s).

  12. Effects of a long-term psychosocial nursing intervention on adolescents exposed to catastrophic stress.

    PubMed

    Hardin, Sally Brosz; Weinrich, Sally; Weinrich, Martin; Garrison, Carol; Addy, Cheryl; Hardin, Thomas L

    2002-09-01

    This research tested the effects of a long-term psychosocial nursing intervention designed to decrease mental distress in adolescents following a catastrophic event. Advanced Practice Psychiatric Nurses conducted the Catastrophic Stress Intervention (CSI) in two South Carolina high schools for three years following Hurricane Hugo. The CSI consisted of nine protocols designed to decrease adolescents' mental distress by increasing their understanding of stress and by enhancing their self-efficacy and social support. Adolescents (N = 1030) were randomized to intervention or control groups and completed one baseline and five postintervention measures of mental distress, self-efficacy, and social support. The hypothesis was that intervention adolescents would have less mental distress than control adolescents. The research also addressed the particular time points at which differences between intervention and control adolescents might be shown. Repeated measures multivariate analysis of variance, with exposure to the hurricane, self-efficacy, and social support as control variables, showed that intervention adolescents reported less mental distress than control adolescents at 12, 18, and 24 months but that this difference dissipated by 30 and 36 months. Implications for the CSI and timing of interventions with adolescents after a catastrophic event are discussed.

  13. Perceptions of Malawian nurses about nursing interventions for malnourished children and their parents.

    PubMed

    Johansson, Magdalena; Nyirenda, John L Z; Johansson, AnnaKarin; Lorefält, Birgitta

    2011-12-01

    In developing countries, malnutrition among children is a major public-health issue. The aim of the study was to describe perceptions of Malawian nurses about nursing interventions for malnourished children and their parents. A qualitative method was used. Data were collected and analyzed according to the phenomenographic research approach. Twelve interviews were performed with 12 nurses at a rural hospital in northern Malawi, Southeast Africa. Through the analysis, two major concepts, comprising four categories of description, emerged: managing malnutrition today and promotion of a favourable nutritional status. The categories of description involved identification and treatment of malnutrition, education during treatment, education during prevention, and assurance of food security. The participating nurses perceived education to be the most important intervention, incorporated in all areas of prevention and treatment of malnutrition. Identification and treatment of malnutrition, education during treatment, education to prevent malnutrition, and assurance of food security were regarded as the most important areas of intervention.

  14. Transtheoretical Model-based Nursing Intervention on Lifestyle Change: A Review Focused on Intervention Delivery Methods.

    PubMed

    Lee, Joo Yun; Park, Hyeoun-Ae; Min, Yul Ha

    2015-06-01

    The transtheoretical model (TTM) was used to provide tailored nursing for lifestyle management such as diet, physical activity, and smoking cessation. The present study aims to assess the provision of intervention delivery methods, intervention elements, and stage-matched interventions, in order to identify ways in which information technology is used in the TTM-based research. The relevant literature was selected by two researchers using inclusion criteria after searching for "TTM (transtheoretical or stage of change)" and "nursing" from the databases PubMed and CINAHL. The selected studies were categorized in terms of study characteristics, intervention delivery method, intervention element, and use and level of stage-matched intervention. A total of 35 studies were selected including eight studies that used information communication technology (ICT). Nine different intervention delivery methods were used, of which "face-to-face" was the most common at 24 times. Of the 35 studies, 26 provided stage-matched interventions. Seven different intervention elements were used, of which "counseling" was the most common at 27 times. Of all the intervention elements, tailored feedback used ICT the most at seven instances out of nine, and there was a significant difference in the rate of ICT usage among intervention elements. ICT is not yet actively used in the TTM-based nursing interventions. Stage-matched interventions and TTM concepts were shown to be in partial use also in the TTM-based interventions. Therefore, it is necessary to develop a variety of ways to use ICT in tailored nursing interventions and to use TTM frameworks and concepts. Copyright © 2015. Published by Elsevier B.V.

  15. The School Nurse's Role in Homeopathic Interventions.

    ERIC Educational Resources Information Center

    Selekman, Janice; Thomas, Elizabeth; McLean, Kay

    1998-01-01

    Describes the practices of homeopathy and how they affect the scope of practice of school nurses. Includes a definition of homeopathy, a discussion of remedies and the specific symptoms for which they are effective, and an examination of conditions treatable by homeopathic physicians. Nine guidelines for managing homeopathic products in the school…

  16. The School Nurse's Role in Homeopathic Interventions.

    ERIC Educational Resources Information Center

    Selekman, Janice; Thomas, Elizabeth; McLean, Kay

    1998-01-01

    Describes the practices of homeopathy and how they affect the scope of practice of school nurses. Includes a definition of homeopathy, a discussion of remedies and the specific symptoms for which they are effective, and an examination of conditions treatable by homeopathic physicians. Nine guidelines for managing homeopathic products in the school…

  17. [Establishment of a nursing-driven sedation protocol: effect on the sedation level and accidental withdrawal of tubes and catheters].

    PubMed

    Arias-Rivera, S; Sánchez-Sánchez, M M; Sánchez-Izquierdo, R; Gallardo-Murillo, M J; Santos-Díaz, R I; Frutos-Vivar, F

    2008-01-01

    Mechanically ventilated patients require sedation during ventilatory support. Our study has aimed to determine if the effects on the sedation level of a nursing-driven sedation protocol has any influence in the accidental removal of tubes and catheters. A quasi-experimental intervention study was performed in a medical-surgical intensive care unit. A 17-month pre-intervention observational period was followed by a 17-month intervention period where a nursing-driven sedation protocol based on the Glasgow Coma Score modified by Cook and Palma was implemented. In both periods, we registered the accidental removals of endotracheal tube, nasogastric tube, urinary catheter and intravascular catheters. A total of 176 patients (age: 65 +/- 17 years; SAPS II: 43 +/- 14) were included in the observation period and 189 patients (age: 65 +/- 15 years; SAPS II: 40 +/- 13) in the intervention period. In second period, the percentage of patients excessively sedated decreased (20% vs. 41%; p = 0.001) and the percentage of patients with optimal sedation increased (53% vs. 35%; p < 0.001). The rate of accidental removals of enteral tubes in the first period was 15.8 per 1,000 tube-days vs. 5.6 in the second period (p = 0.001). No accidental removal of intravascular catheters was found in the second period vs. a rate of 2.6 central venous catheters per 1,000 catheter-days and a rate of 3.4 intra-arterial catheters per 1,000 catheter-days during the first period. Implementation of a nursing-driven sedation protocol increases the percentage of patients with an optimal sedation and decreases the incidence of accidental removal of tubes and catheters.

  18. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study.

    PubMed

    Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke Jah; Schoonhoven, Lisette; Koopmans, Raymond Tcm; Laurant, Miranda Gh

    2017-06-08

    In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context-mechanism-outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. © Article author(s) (or their employer(s) unless otherwise stated

  19. Examining the feasibility of implementing specific nursing interventions to promote sleep in hospitalized elderly patients.

    PubMed

    Lareau, Rita; Benson, Linda; Watcharotone, Kuanwong; Manguba, Grace

    2008-01-01

    Sleep deprivation and subsequent effects on health restoration have been documented in the literature. The purpose of this experimental pilot study was to examine the feasibility of implementing specific nursing interventions to promote sleep in hospitalized older adults. The experimental group received a sleep protocol intervention while the control group received usual nighttime care. While no differences were noted in sleep quality and duration between groups, the experimental group experienced better sleep quality (P = .001), ability to remain asleep (P = .018) and used fewer sleep medications than the control group (P = .044). In addition, those taking sleep medications experienced more awakenings and fewer sleep hours. Experimental group patients identified preferences such as personal hygiene, awareness of normal bedtime, receiving a back rub, straightening bed linens, and receiving a bedtime snack. This pilot provides initial support for the feasibility and utility of implementing a sleep protocol in an acute care setting.

  20. Pilot Test of a Culturally Sensitive Hypertension Management Intervention Protocol for Older Chinese Immigrants: Chinese Medicine as Longevity Modality.

    PubMed

    Li, Wen-Wen; Gomez, Cynthia A; Tam, Jocelyn Wing-Yin

    2015-11-01

    Hypertension control in older Chinese immigrants remains a significant health issue because of their unique cultural health practices to manage their hypertension. At present, there are limited culturally sensitive health education materials regarding hypertension management tailored for the older Chinese population available for and feasible to use. Because the San Francisco Bay Area has a large population of older Chinese immigrants, development of a culturally appropriate intervention is important to help this population achieve better blood pressure control. The focus of this study was to develop and test the feasibility of a culturally sensitive hypertension management intervention protocol, Chinese Medicine as Longevity Modality. This intervention protocol is implemented as a patient education health program delivered via video format in combination with an individual consultation provided by a nurse in the initial intervention, followed by four phone calls between the initial intervention and the second follow-up visit. The results of the study showed that the proposed intervention protocol was acceptable for the target population.

  1. Practice protocol: transition to community nursing practice revisited.

    PubMed

    Ellis, Irene; Chater, Keri

    2012-08-01

    The purpose of this paper is to explore and describe the process of transition that nurses experience when moving from the acute sector to a specialist area of community nursing. Issues explored include the increased movement of nurses into the community sector, the experience of culture shock and changes in nursing roles. Transition issues including the need for effective management and infrastructure support, mentoring and preceptorship, skills acquisition and continuing education will be examined. Joint implementation of what is successful at both university and industry levels can improve the transition to community nursing.

  2. Southeast Asian refugee women and depression: a nursing intervention.

    PubMed

    Fox, P G; Cowell, J M; Montgomery, A C; Willgerodt, M A

    1998-04-01

    Globally, conflicts continue to result in large numbers of refugees and displaced persons, the majority are women. At present, there is scant literature on the mental health status of refugee women following resettlement in countries that grant asylum. We do know that adaptation following migration is a complex cultural, psychological and social process. Some studies have suggested a high prevalence of depression symptoms related to premigration and post-migration experiences. The purpose of this paper will be to describe the mental health status of Southeast Asian (S.E.A.) refugee women in the United States, before home visit interventions by school nurses and bilingual teachers, and at 10, 20 and 33 weeks following the intervention. A comparison group of S.E.A. refugee women, who did not receive the intervention, were evaluated for mental health status on two occasions ten weeks apart. The identified needs and problems identified by the women, the interventions implemented by the school nurses and the success of the interventions will also be discussed. The underlying problem for the majority of women was poverty and social isolation. The study demonstrates that indeed, refugee women in the U.S., are experiencing needs and problems related to basic survival issues in multiple areas of their lives. The findings suggest that home visit interventions by nurses may be a valuable means of reducing depression in S.E.A. refugee women.

  3. Nurse practitioner-led transitional care interventions: An integrative review.

    PubMed

    Mora, Kathlyen; Dorrejo, Xiomara M; Carreon, Kimberly Mae; Butt, Sadia

    2017-08-28

    Chronically ill patients 65 and above have an increased risk of preventable readmission within 30 days of discharge from the hospital. The Transitional Care Model (TCM) introduced by Naylor and colleagues was implemented to improve the transition between hospital and home while decreasing readmissions. This article examines whether nurse practitioner (NP)- led TCM interventions as compared to standard care decrease hospital readmission rates in older adults. A literature review was conducted from June 2016 to March 2017 using Cochrane Library, PubMed, Cumulative Index to Nursing and Health Literature (CINAHL) PLUS, Joanna Briggs Institute, and ProQuest Central to seek out the highest level of evidence. Search results were refined to focus on randomized control trials (RTCs) containing NP-led TCM interventions with older adults. Synthesis of three RTCs, one meta-analysis, and four nonrandomized studies reviewed TCM interventions that included these interventions: follow-up phone calls post discharge, home visits, and handoff of information to the patient's primary care provider. These interventions, although not exclusively led by NPs, decreased hospital readmission rates. NP-led TCM interventions have the potential to decrease readmissions, but the level of evidence is insufficiently high to allow for generalizability, warranting further study. ©2017 American Association of Nurse Practitioners.

  4. Nursing diagnoses and interventions in children submitted to cochlear implantation.

    PubMed

    Pereira, Patrícia Juliana Santos; Souza, Natália Fernanda Higa de; Almeida, Raissa Janine de; Menezes, Daiane Cabrera; Bom, Gesiane Cristina; Trettene, Armando Dos Santos

    2017-06-12

    Identifying the main nursing diagnoses and interventions in children submitted to cochlear implant in the immediate postoperative period. A cross-sectional study conducted between February and April 2016, considering nursing history (anamnesis and physical examination) and nursing diagnoses (NANDA - International) with their respective interventions (Nursing Intervention Classification - NIC). Descriptive statistical analysis was used to construct the results. A total of 19 children participated in this study. The main nursing diagnoses listed were: impaired verbal communication, impaired skin integrity, risk for infection, risk for falls, and risk for bleeding (n=19; 100%). Regarding the nursing interventions, the following prevailed: Improvement in communication: auditory deficit, Skin surveillance, Protection against infection, Prevention of falls and Precautions against bleeding (n=19; 100%). Nursing diagnoses and interventions related to the cochlear implant postoperative period were related to communication, bleeding control, surgical wound care, infection prevention, comfort and well-being. Identificar os principais diagnósticos e intervenções de enfermagem em crianças submetidas a implante coclear em pós-operatório imediato. Estudo transversal realizado entre fevereiro e abril de 2016. Foram considerados o histórico de enfermagem (anamnese e exame físico) e os diagnósticos de enfermagem (NANDA - Internacional) com suas respectivas intervenções (Nursing Intervention Classification - NIC). Para construção dos resultados utilizou-se da análise estatística descritiva. Participaram do presente estudo 19 crianças. Os principais diagnósticos de enfermagem elencados foram: Comunicação verbal prejudicada, Integridade da pele prejudicada, Risco de infecção, Risco de queda e Risco de sangramento (n=19; 100%). Quanto às intervenções de enfermagem, prevaleceram: Melhora na comunicação: deficit auditivo, Supervisão da pele, Proteção contra

  5. Positioning clinical nurse specialists and nurse practitioners as change champions to implement a pain protocol in long-term care.

    PubMed

    Kaasalainen, Sharon; Ploeg, Jenny; Donald, Faith; Coker, Esther; Brazil, Kevin; Martin-Misener, Ruth; Dicenso, Alba; Hadjistavropoulos, Thomas

    2015-04-01

    Pain management for older adults in long-term care (LTC) has been recognized as a problem internationally. The purpose of this study was to explore the role of a clinical nurse specialist (CNS) and nurse practitioner (NP) as change champions during the implementation of an evidence-based pain protocol in LTC. In this exploratory, multiple-case design study, we collected data from two LTC homes in Ontario, Canada. Three data sources were used: participant observation of an NP and a CNS for 18 hours each over a 3-week period; CNS and NP diaries recording strategies, barriers, and facilitators to the implementation process; and interviews with members of the interdisciplinary team to explore perceptions about the NP and CNS role in implementing the pain protocol. Data were analyzed using thematic content analysis. The NP and CNS used a variety of effective strategies to promote pain management changes in practice including educational outreach with team members, reminders to nursing staff to highlight the pain protocol and educate about practice changes, chart audits and feedback to the nursing staff, interdisciplinary working group meetings, ad hoc meetings with nursing staff, and resident assessment using advanced skills. The CNS and NP are ideal champions to implement pain management protocols and likely other quality improvement initiatives.

  6. Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides.

    PubMed

    Sprangers, Suzan; Dijkstra, Katinka; Romijn-Luijten, Anna

    2015-01-01

    Effective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home staff and nursing home residents with dementia. These studies have shown that communication skills training can improve nursing aides' communication with nursing home residents. However, these studies tended to be time-consuming and fairly difficult to implement. Moreover, these studies focused on the communicative benefits for the nursing home residents and their well-being, while benefits and well-being for the nursing aides were neglected. The current study focused on implementing a brief communication skills training program to improve nursing aides' (N=24) communication with residents with dementia (N=26) in a nursing home. The effects of the training on nursing aides' communication, caregiver distress, and job satisfaction and residents' psychopathology and agitation were assessed relative to a control group condition. Nursing aides in the intervention group were individually trained to communicate effectively with residents during morning care by using short instructions, positive speech, and biographical statements. Mixed ANOVAs showed that, after training, nursing aides in the intervention group experienced less caregiver distress. Additionally, the number of short instructions and instances of positive speech increased. Providing nursing aides with helpful feedback during care aids communication and reduces caregiver burden, even with a brief intervention that requires limited time investments for nursing home staff.

  7. Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides

    PubMed Central

    Sprangers, Suzan; Dijkstra, Katinka; Romijn-Luijten, Anna

    2015-01-01

    Effective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home staff and nursing home residents with dementia. These studies have shown that communication skills training can improve nursing aides’ communication with nursing home residents. However, these studies tended to be time-consuming and fairly difficult to implement. Moreover, these studies focused on the communicative benefits for the nursing home residents and their well-being, while benefits and well-being for the nursing aides were neglected. The current study focused on implementing a brief communication skills training program to improve nursing aides’ (N=24) communication with residents with dementia (N=26) in a nursing home. The effects of the training on nursing aides’ communication, caregiver distress, and job satisfaction and residents’ psychopathology and agitation were assessed relative to a control group condition. Nursing aides in the intervention group were individually trained to communicate effectively with residents during morning care by using short instructions, positive speech, and biographical statements. Mixed ANOVAs showed that, after training, nursing aides in the intervention group experienced less caregiver distress. Additionally, the number of short instructions and instances of positive speech increased. Providing nursing aides with helpful feedback during care aids communication and reduces caregiver burden, even with a brief intervention that requires limited time investments for nursing home staff. PMID:25653513

  8. A Behavioral Intervention for Death Anxiety in Nurses.

    ERIC Educational Resources Information Center

    White, Pamela Diane; And Others

    1983-01-01

    Conducted a treatment outcome study to evaluate change in death anxiety in nursing students (N=24) as a result of systematic desensitization, relaxation training, and no intervention. Both the desensitization and relaxation groups were more effective than no treatment. Improvement of available dependent measures of death anxiety is needed.…

  9. [Effective interventions to reduce absenteeism among hospital nurses].

    PubMed

    Blanca-Gutiérrez, Joaquín Jesús; Jiménez-Díaz, María del Carmen; Escalera-Franco, Luis Felipe

    2013-01-01

    To select and summarize the interventions that have proved effective in reducing absenteeism among hospital nurses. A scoping review was conducted through a literature search using Medline, Web of Science, Cinahl, Embase, Lilacs, Cuiden and Cochrane Library Plus databases. Of a total of 361 articles extracted, 15 were finally selected for this review. The implementation of multifaceted support or physical training programs can produce positive results in terms of reducing absenteeism among hospital nurses. Cognitive-behavioral type interventions require studies with larger samples to provide conclusive results. Establishing more flexible working shifts may also reduce absenteeism rates, although again studies with larger samples are needed. Programs aimed at managing change developed by nurses themselves, participatory management of professional relations, the support provided by supervisors who are opposed to hierarchical leadership styles, and wage supplements that reward the lack of absence can also reduce these types of indicators. Absenteeism can be considered as a final result and a consequence of the level of job satisfaction. The effectiveness of interventions to reduce absenteeism among hospital nurses will no doubt largely depend on the ability of these interventions to increase the job satisfaction of these workers. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Critical incident stress debriefing: a family nursing intervention.

    PubMed

    Ragaisis, K M

    1994-02-01

    Critical Incident Stress Debriefing is an intervention that assists patients and families to master the stresses resulting from being a witness to or victim of violent acts. Intervening at the level of the family system, the clinical nurse specialist can facilitate communication, decrease anxiety, and provide education regarding the post-trauma response.

  11. A Pilot of a Gerontological Advanced Practice Nurse Preventive Intervention

    ERIC Educational Resources Information Center

    Hahn, Joan Earle; Aronow, Harriet Udin

    2005-01-01

    Background: Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community-based health care systems. As they age into middle years, they are at increased risk for functional decline. This paper presents a description of an advanced practice nurse (APN) intervention used in a pilot…

  12. Studying nursing interventions in acutely ill, cognitively impaired older adults

    PubMed Central

    McCauley, Kathleen; Bradway, Christine; Hirschman, Karen B; Naylor, Mary D

    2015-01-01

    Background Between one and two of every five hospitalized older adults have cognitive deficits, often not accurately assessed or well managed. Cognitive impairment adds substantially to the complexity of these patients’ care, places them at high risk for poor outcomes and increases the cost of health care. Methods We describe three evidence-based interventions, each capitalizing on the unique contributions of nurses and designed to improve outcomes of hospitalized older adults who have cognitive deficits. Interventions of varying intensity were compared across three hospitals (Phase I) and subsequently within the same hospitals (Phase II). All enrolled patients were screened during their index hospitalizations and cognitive deficits were communicated to relevant health care team members (Augmented Standard Care-ASC, lowest intensity). At one hospital, ASC was the only intervention. Patients at a second hospital also had care influenced by specially prepared registered nurses (Resource Nurse Care-RNC, medium intensity). Finally, patients at third hospital also received advanced practice nurse coordinated care (Transitional Care Model-TCM, higher intensity). In Phase II, newly enrolled patients at these same hospitals all received the TCM. We summarize major themes from review of multiple data sources and researcher recollections related to facilitators and barriers to implementing a complex research study. Findings Effective implementation of the three intervention strategies depended on clinician engagement and communication; degree of participation by nurses in the educational program with subsequent practice improvement; and success of advanced practice nurses in implementing the TCM with both with patients, family caregivers and clinicians. Implications Based on lessons learned in implementing complex research studies within the “real world” of clinical practice settings, recommendations focus on strengthening facilitators, minimizing barriers and gaining

  13. A cluster randomized trial on improving nurses' detection and management of elder abuse and neglect (I-NEED): study protocol.

    PubMed

    Loh, Debbie Ann; Choo, Wan Yuen; Hairi, Noran Naqiah; Othman, Sajaratulnisah; Mohd Hairi, Farizah; Mohd Mydin, Fadzilah Hanum; Jaafar, Siti Nur Illiani; Tan, Maw Pin; Mohd Ali, Zainudin; Abdul Aziz, Suriyati; Ramli, Rohaya; Mohamad, Rosmala; Lal Mohammad, Zaiton; Hassan, Norlela; Brownell, Patricia; Bulgiba, Awang

    2015-11-01

    The aim of this study was to describe a trial protocol of an educational intervention for nurses to improve their awareness and practice in detecting and managing elder abuse and neglect. Knowledgeable and skilful nurses are crucial amidst the growing numbers of maltreated older patients. This trial is a multi-site, three-armed, community-based cluster randomized controlled trial with 6-months follow-up. This study will involve 390 community and registered nurses from government health clinics in Negeri Sembilan, Malaysia (protocol approved in October 2013). This three-phased study, premised on the Precede-Proceed Model, comprises baseline focus group discussion and survey (Phase 1), development of training module (Phase 2) and implementation and evaluation of the training (Phase 3). Eligible participants will be randomized to the control group (continuous nursing education), intervention group A (face-to-face intensive training programme) or group B (face-to-face intensive training programme and an educational video). Outcome measures include improvement in knowledge and awareness on elder abuse and neglect and the number of cases identified and managed during follow-up. Data will be collected at baseline, immediate postintervention, 3- and 6-month follow-up. Findings from this study will provide empirical support for the development of a training module for nurses on the detection and management of elder abuse and neglect, towards improving healthcare delivery and the well-being of vulnerable older adults. This study is funded by the University of Malaya Research Grant (RP001C-13HTM), (FL002-13SBS) and University of Malaya Grand Challenge (PEACE) Grant (GC001C-14HTM) awarded in May 2013, July 2013 and September 2014. © 2015 John Wiley & Sons Ltd.

  14. Communication that builds teams: assessing a nursing conflict intervention.

    PubMed

    Nicotera, Anne Maydan; Mahon, Margaret M; Wright, Kevin B

    2014-01-01

    Quality communication is essential for building strong nursing teams. Structurational divergence (SD) theory explains how institutional factors can result in poor communication and conflict cycles; the theory has been developed in nursing context, although it is applicable to all organizational settings. We describe the design, implementation, and evaluation of an intervention to reduce SD and improve nurses' work life and team-member relationships. An intensive 9-hour course provided training in conflict/SD analysis and dialogic conflict/SD management to 36 working nurses from a variety of settings. Quantitative pre- and posttests were administered, with a comparison sample. The course reduced measures of negative conflict attitudes and behaviors: direct personalization, persecution feelings, negative relational effects, ambiguity intolerance, and triangulation (gossiping and complaining to uninvolved third parties). The course also increased important attitudes necessary for productive dialogue and conflict management: perceptions of positive relational effects, conflict liking, and positive beliefs about arguing. As compared with nonparticipants, participant posttests showed lower conflict persecution; higher recognition of positive relational effects; lower perceptions of negative relational effects; higher conflict liking; lower ambiguity intolerance; and lower tendency to triangulate. Qualitatively, participants perceived better understanding of, and felt more empowered to manage, workplace conflicts and to sustain healthier workplace relationships. This intervention can help nurses develop tools to improve system-level function and build productive team relationships.

  15. Tobacco intervention practices of postsecondary campus nurses in Ontario.

    PubMed

    Lawrance, Kelli-an G; Travis, Heather Elizabeth; Lawler, Sharon A

    2012-12-01

    Cessation interventions offered by nurses to postsecondary students could represent an important strategy for reducing smoking among young adults. This study examines how nurses working in campus health clinics identify smokers and provide cessation support. Of 108 nurses working at 16 universities in the Canadian province of Ontario, 83 completed a researcher-designed questionnaire. Of these, 8.2% asked almost all patients about their tobacco use and 27.4% asked almost none; 83.1% advised identified smokers to quit, 63.9% offered them assistance, and 59.0% arranged follow-up visits. Smoking was most often assessed during patient visits for respiratory or cardiovascular concerns. Assistance most often involved referral of smokers to other professionals or services. A government-funded tobacco control initiative implemented on 10 of the 16 campuses had limited influence on whether nurses assessed tobacco use and advised cessation. Education and support may be needed to improve the frequency and quality of tobacco interventions provided by nurses working on postsecondary campuses.

  16. Feasibility of using the Omaha System to represent public health nurse manager interventions.

    PubMed

    Monsen, Karen A; Newsom, Eric T

    2011-01-01

    To test the feasibility of representing public health nurse (PHN) manager interventions using a recognized standardized nursing terminology. A nurse manager in a Midwest local public health agency documented nurse manager interventions using the Omaha System for 5 months. ANALYTIC STRATEGY: The data were analyzed and the results were compared with the results from a parallel analysis of existing PHN intervention data. Interventions for 79 "clients" (projects, teams, or individuals) captured 76% of recorded work hours, and addressed 43% of Omaha System problems. Most problems were addressed at the "community" level (87.1%) versus the "individual" level (12.9%). Nursing practice differed between the 2 knowledge domains of public health family home visiting nursing and public health nursing management. Standardized nursing terminologies have the potential to represent, describe, and quantify nurse manager interventions for future evaluation and research. © 2011 Wiley Periodicals, Inc.

  17. The impact of protocol on nurses' role stress: a longitudinal perspective.

    PubMed

    Dodd-McCue, Diane; Tartaglia, Alexander; Veazey, Kenneth W; Streetman, Pamela S

    2005-04-01

    The study examined the impact of a protocol directed at increasing organ donation on the role stress and work attitudes of critical care nurses involved in potential organ donation cases. The research examined whether the protocol could positively affect nurses' perceptions of role stress, and if so, could the work environment improvements be sustained over time. The Family Communication Coordinator (FCC) protocol promotes effective communication during potential organ donation cases using a multidisciplinary team approach. Previous research found it associated with improved donation outcomes and with improved perceptions of role stress by critical care nurses. However, the previous study lacked methodological rigor necessary to determine causality and sustainability over time. The study used a quasi-experimental prospective longitudinal design. The sample included critical care nurses who had experience with potential organ donation cases with the protocol. Survey data were collected at 4 points over 2 years. Surveys used previously validated and reliable measures of role stress (role ambiguity, role conflict, role overload) and work attitudes (commitment, satisfaction). Interviews supplemented these data. The nurses' perceptions of role stress associated with potential organ donation cases dramatically dropped after the protocol was implemented. All measures of role stress, particularly role ambiguity and role conflict, showed statistically significant and sustained improvement. Nurses' professional, unit, and hospital commitment and satisfaction reflect an increasingly positive workplace. The results demonstrate that the FCC protocol positively influenced the workplace through its impact on role stress over the first 2 years following its implementation. The findings suggest that similar protocols may be appropriate in improving the critical care environment by reducing the stress and uncertainty of professionals involved in other end-of-life situations. However

  18. Nurse coaching and cartoon distraction: an effective and practical intervention to reduce child, parent, and nurse distress during immunizations.

    PubMed

    Cohen, L L; Blount, R L; Panopoulos, G

    1997-06-01

    Evaluated a low cost and practical intervention designed to decrease children's, parents', and nurses' distress during children's immunizations. The intervention consisted of children viewing a popular cartoon movie and being coached by nurses and parents to attend to the movie. Ninety-two children, 4-6 years of age, and their parents were alternatively assigned to either a nurse coach intervention, a nurse coach plus train parent and child intervention, or a standard medical care condition. Based on previous findings of generalization of adult behaviors during medical procedures, it was hypothesized that training only the nurses to coach the children would cost-effectively reduce all participants levels of distress. Observational measures and subjective ratings were used to assess the following dependent variables: children's coping, distress, pain, and need for restraint; nurses' and parents' coaching behavior; and parents' and nurses' distress. Results indicate that, in the two intervention conditions, children coped more and were less distressed, nurses and parents exhibited more coping promoting behavior and less distress promoting behavior, and parents and nurses were less distressed than in the control condition. Although neither intervention was superior on any of the variables assessed in the study, nurse coach was markedly more practical and cost-effective. Therefore, nurses' coaching of children to watch cartoon movies has great potential for dissemination in pediatric settings.

  19. Nursing home resident outcomes from the Res-Care intervention.

    PubMed

    Resnick, Barbara; Gruber-Baldini, Ann L; Zimmerman, Sheryl; Galik, Elizabeth; Pretzer-Aboff, Ingrid; Russ, Karin; Hebel, J Richard

    2009-07-01

    To test the effectiveness of a restorative care (Res-Care) intervention on function, muscle strength, contractures, and quality of life of nursing home residents, with secondary aims focused on strengthening self-efficacy and outcome expectations. A randomized controlled repeated-measure design was used, and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care intervention. Twelve nursing homes in Maryland. Four hundred eighty-seven residents consented and were eligible: 256 from treatment sites and 231 from control sites. The majority were female (389, 80.1%) and white (325, 66.8%); 85 (17.4%) were married and the remaining widowed, single, or divorced/separated. Mean age was 83.8 +/- 8.2, and mean Mini-Mental State Examination score was 20.4 +/- 5.3. Res-Care was a two-tiered self-efficacy-based intervention focused on motivating nursing assistants and residents to engage in functional and physical activities. Barthel Index, Tinetti Gait and Balance, grip strength, Dementia Quality-of-Life Scale, self-efficacy, and Outcome Expectations Scales for Function. Significant treatment-by-time interactions (P<.05) were found for the Tinetti Mobility Score and its gait and balance subscores and for walking, bathing, and stair climbing. The findings provide some evidence for the utility and safety of a Res-Care intervention in terms of improving function in NH residents.

  20. Partner randomized controlled trial: study protocol and coaching intervention.

    PubMed

    Garbutt, Jane M; Highstein, Gabrielle; Yan, Yan; Strunk, Robert C

    2012-04-02

    Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. This paper describes the protocol for a randomized controlled trial (RCT) to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1) effective use of controller medications, 2) effective use of rescue medications and 3) monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1) the child's asthma control score, 2) the parent's quality of life score, and 3) the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications, having maintenance care visits at least twice a year

  1. Partner randomized controlled trial: study protocol and coaching intervention

    PubMed Central

    2012-01-01

    Background Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. Methods and design This paper describes the protocol for a randomized controlled trial (RCT) to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1) effective use of controller medications, 2) effective use of rescue medications and 3) monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1) the child's asthma control score, 2) the parent's quality of life score, and 3) the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications, having maintenance

  2. Cost-utility analysis of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses.

    PubMed

    Kaitani, Toshiko; Nakagami, Gojiro; Iizaka, Shinji; Fukuda, Takashi; Oe, Makoto; Igarashi, Ataru; Mori, Taketoshi; Takemura, Yukie; Mizokami, Yuko; Sugama, Junko; Sanada, Hiromi

    2015-01-01

    The high prevalence of severe pressure ulcers (PUs) is an important issue that requires to be highlighted in Japan. In a previous study, we devised an advanced PU management protocol to enable early detection of and intervention for deep tissue injury and critical colonization. This protocol was effective for preventing more severe PUs. The present study aimed to compare the cost-effectiveness of the care provided using an advanced PU management protocol, from a medical provider's perspective, implemented by trained wound, ostomy, and continence nurses (WOCNs), with that of conventional care provided by a control group of WOCNs. A Markov model was constructed for a 1-year time horizon to determine the incremental cost-effectiveness ratio of advanced PU management compared with conventional care. The number of quality-adjusted life-years gained, and the cost in Japanese yen (¥) ($US1 = ¥120; 2015) was used as the outcome. Model inputs for clinical probabilities and related costs were based on our previous clinical trial results. Univariate sensitivity analyses were performed. Furthermore, a Bayesian multivariate probability sensitivity analysis was performed using Monte Carlo simulations with advanced PU management. Two different models were created for initial cohort distribution. For both models, the expected effectiveness for the intervention group using advanced PU management techniques was high, with a low expected cost value. The sensitivity analyses suggested that the results were robust. Intervention by WOCNs using advanced PU management techniques was more effective and cost-effective than conventional care.

  3. Advanced Nursing Process quality: Comparing the International Classification for Nursing Practice (ICNP) with the NANDA-International (NANDA-I) and Nursing Interventions Classification (NIC).

    PubMed

    Rabelo-Silva, Eneida Rejane; Dantas Cavalcanti, Ana Carla; Ramos Goulart Caldas, Maria Cristina; Lucena, Amália de Fátima; Almeida, Miriam de Abreu; Linch, Graciele Fernanda da Costa; da Silva, Marcos Barragan; Müller-Staub, Maria

    2017-02-01

    To assess the quality of the advanced nursing process in nursing documentation in two hospitals. Various standardised terminologies are employed by nurses worldwide, whether for teaching, research or patient care. These systems can improve the quality of nursing records, enable care continuity, consistency in written communication and enhance safety for patients and providers alike. Cross-sectional study. A total of 138 records from two facilities (69 records from each facility) were analysed, one using the NANDA-International and Nursing Interventions Classification terminology (Centre 1) and one the International Classification for Nursing Practice (Centre 2), by means of the Quality of Diagnoses, Interventions, and Outcomes instrument. Quality of Diagnoses, Interventions, and Outcomes scores range from 0-58 points. Nursing records were dated 2012-2013 for Centre 1 and 2010-2011 for Centre 2. Centre 1 had a Quality of Diagnoses, Interventions, and Outcomes score of 35·46 (±6·45), whereas Centre 2 had a Quality of Diagnoses, Interventions, and Outcomes score of 31·72 (±4·62) (p < 0·001). Centre 2 had higher scores in the 'Nursing Diagnoses as Process' dimension, whereas in the 'Nursing Diagnoses as Product', 'Nursing Interventions' and 'Nursing Outcomes' dimensions, Centre 1 exhibited superior performance; acceptable reliability values were obtained for both centres, except for the 'Nursing Interventions' domain in Centre 1 and the 'Nursing Diagnoses as Process' and 'Nursing Diagnoses as Product' domains in Centre 2. The quality of nursing documentation was superior at Centre 1, although both facilities demonstrated moderate scores considering the maximum potential score of 58 points. Reliability analyses showed satisfactory results for both standardised terminologies. Nursing leaders should use a validated instrument to investigate the quality of nursing records after implementation of standardised terminologies. © 2016 John Wiley & Sons Ltd.

  4. Effectiveness of a neck stretching intervention on nurses' primary headaches.

    PubMed

    Lin, Li-Ying; Wang, Ruey-Hsia

    2015-03-01

    This study examined the effects of a neck stretching exercise intervention on nurses' primary headaches. Using a pretest and posttest two-group design, a total of 60 female staff nurses employed by a medical center in Taiwan were selected by convenience sampling. Participants in the experimental group (N=30) practiced neck stretching exercises while experiencing headaches. The participants in the control group (N=30) managed their headaches as usual. A structured questionnaire was used to collect data on headache intensity at baseline, and at 30 minutes and 1 hour after intervention. Decrease in headache intensity of the experimental group was significantly larger than that of the control group. Neck stretching exercises is an effective method for treating primary headaches.

  5. [Effectiveness of a nursing intervention on patient anxiety before transfusion of packed red blood cells].

    PubMed

    Martín Díaz, Jesús Fernando; Hidalgo Gutiérrez, M Jesús; Cerezo Solana, M Fátima; Martín Morcillo, Jaime

    2013-01-01

    To evaluate the effectiveness of an educational intervention regarding anxiety and satisfaction in patients requiring a red blood cell transfusion. Randomised, controlled, single-blind clinical trial in patients requiring a packed red blood cell transfusion. alpha=.05, beta=.10, to detect a 10% difference, 70 subjects in each group. The sampling recruitment was randomised to the intervention group (IG) and the control group (CG). an intervention protocol with oral and written information using a published guide on the safety, risks and benefits of haemotherapy for the IG, and an equivalent one on general health topics for the CG. pre- and post-anxiety state; Spielberger's validated questionnaire: STAI. Satisfaction, by an ad hoc questionnaire. Sociodemographic and clinical variables: description, reason for transfusion, prescription knowledge, incidents, records. There was a total of 144 subjects, 73 (50.69%) in the IG, and 71 (49.31%) in the CG. The mean age was 55.80 years, with 56.94% males, and a first transfusion in 52.08%. Comparability between the IG and the CG was tested and confirmed. The decrease in anxiety after the intervention for the IG was 19.99, compared to 25.48 in CG. The difference was greater than the proposed 10%, and was statistically significant. The preference for information was 98.60% in IG, compared to 43.70% in CG. The hypothesis was confirmed; a protocolised nursing educational intervention protocol increased patient satisfaction with nursing care, and decreased patient anxiety, thus preventing complications and providing greater safety to the users. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  6. Tactile massage as a nursing intervention in child and adolescent psychiatry: nurses' experiences.

    PubMed

    Robertz, A-C; Rudolfsson, G

    2016-10-01

    WHAT IS KNOWN ABOUT THE SUBJECT?: There is little research on the implementation of tactile massage in child and adolescent psychiatry that describes children's and adolescents' experiences and outcomes. There is also limited knowledge of providing tactile massage in child and adolescent psychiatry. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper describes 10 nurses' experiences of tactile massage as a nursing intervention in child and adolescent psychiatry. The nurses considered tactile massage a non-verbal nursing intervention that could complement other available treatments. It reveals their reflections on the impact of tactile massage on their nursing and on themselves as a person, including the belief that they had developed deepened self-reflection and attentiveness. The nurses highlighted the importance of providing a trusting environment and collaborating with the children and adolescents. They both experienced and observed that tactile massage triggered various physical and mental processes in the children and adolescents, such as improvement in sleep disturbances, an ability to relax in body and mind and a deeper connectedness with their own bodies and feelings. The nurses described instructing next of kin in the use of tactile massage, which they believed could serve as a tool at home, mainly as a way for next of kin to help their children to relax, fall asleep more easily and to deepen connectedness. However, the nurses stressed the need to consider if it was appropriate or desired by the children and adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Tactile massage addresses the individual's emotional and physiological responses and could therefore bring holistic nursing to child and adolescent psychiatry. It could also help nurses in child and adolescent psychiatry to develop their attentiveness and sensitivity in acknowledging the needs of children and adolescents in psychiatric care. Introduction There is limited research on tactile

  7. Coping with threats of terrorism: a protocol for group intervention.

    PubMed

    Ottenstein, Richard J

    2003-01-01

    This article presents a group protocol designed to assist people in coping with direct and ongoing threats of terrorism. The protocol is intended to enable participants to address the psychological issues necessary to cope during periods of extreme threat. A step-by-step description of the protocol is provided.

  8. Balancing nurses' workload in hospital wards: study protocol of developing a method to manage workload

    PubMed Central

    van den Oetelaar, W F J M; van Stel, H F; van Rhenen, W; Stellato, R K; Grolman, W

    2016-01-01

    Introduction Hospitals pursue different goals at the same time: excellent service to their patients, good quality care, operational excellence, retaining employees. This requires a good balance between patient needs and nursing staff. One way to ensure a proper fit between patient needs and nursing staff is to work with a workload management method. In our view, a nursing workload management method needs to have the following characteristics: easy to interpret; limited additional registration; applicable to different types of hospital wards; supported by nurses; covers all activities of nurses and suitable for prospective planning of nursing staff. At present, no such method is available. Methods/analysis The research follows several steps to come to a workload management method for staff nurses. First, a list of patient characteristics relevant to care time will be composed by performing a Delphi study among staff nurses. Next, a time study of nurses’ activities will be carried out. The 2 can be combined to estimate care time per patient group and estimate the time nurses spend on non-patient-related activities. These 2 estimates can be combined and compared with available nursing resources: this gives an estimate of nurses’ workload. The research will take place in an academic hospital in the Netherlands. 6 surgical wards will be included, capacity 15–30 beds. Ethical considerations The study protocol was submitted to the Medical Ethical Review Board of the University Medical Center (UMC) Utrecht and received a positive advice, protocol number 14-165/C. Discussion This method will be developed in close cooperation with staff nurses and ward management. The strong involvement of the end users will contribute to a broader support of the results. The method we will develop may also be useful for planning purposes; this is a strong advantage compared with existing methods, which tend to focus on retrospective analysis. PMID:28186931

  9. What, why, and how care protocols are implemented in Ontario nursing homes.

    PubMed

    Berta, Whitney; Ginsburg, Liane; Gilbart, Erin; Lemieux-Charles, Louise; Davis, Dave

    2013-03-01

    The aim of this study was to better understand care protocol implementation, including the influence of organizational-contextual factors on implementation approaches, in long-term care homes operating in Ontario. We surveyed directors of care employed in all 547 Ontario LTC homes, and combined survey data with secondary organizational data on rural/urban location, nursing home size, chain membership, type of ownership, and accreditation status. Motivations for the use/selection of care protocols in nursing homes primarily derived from beliefs in continuous improvement and in evidence-based care. Protocol selection was largely participative, involving management and staff. External information sources were important for protocol implementation, and in-service education was the chief means of training and educating staff. Significant differences in approaches to implementation were evident in association with differences in ownership. Three key success factors for implementation were identified: contextualizing the practice change, adequately resourcing for implementation, and demonstrating connections between practice change and outcomes.

  10. Assessment of Mobile Health Nursing Intervention Knowledge among Community Health Nurses in Oyo State, Nigeria.

    PubMed

    Titilayo, Odetola D; Okanlawon, F A

    2014-09-01

    Maternal mortality is high in Nigeria especially in rural areas due to knowledge deficit about expected care and labour process, socio-cultural belief, health care workers' attitude, physical and financial barriers to quality health care access. Mobile health (m-health) technology which is the use of mobile telecommunication devices in health care delivery reduces costs, improves care access, removes time and distance barriers and facilitates patient-provider communications needed to make appropriate health decisions. Previous studies empowering nurses with m-health knowledge resulted in improved uptake of health care services. There exists a literature dearth about knowledge and perception of nurses in Nigeria. This study became expedient to empower nurses working at the grassroots with the knowledge of m-health and assess the impact of educational training on their perception of its effectiveness. This quasi-experimental study carried out in four randomly selected LGAs across Oyo South Senatorial district involved participants at experimental (20 nurses) and control levels (27 nurses). A validated 25-item questionnaire explored nurses' perception, knowledge and perceived effectiveness of m-health in improving uptake of maternal health services in Nigeria among both groups before intervention. Intervention group nurses had a training equipping them with knowledge of m-health nursing intervention (MNHI) for a period of one week. Their perception, knowledge and perceived effectiveness were re-assessed at three-months and six-months after MHNI. Data were analyzed using Chi-square and repeated measures ANOVA at 5% significance level. In the EG, knowledge score significantly increased from 21.9±4.5 at baseline to 23.6±4.6 and 23.2±5.6 at three-month and six-month respectively while there was no significant difference in knowledge score among CG over the study period. A very significant difference was shown in the knowledge and perception of mobile health and its

  11. Mapping VIPS concepts for nursing interventions to the ISO reference terminology model for nursing actions: A collaborative Scandinavian analysis.

    PubMed

    Ehnfors, Margareta; Angermo, Lilly Marit; Berring, Lene; Ehrenberg, Anna; Lindhardt, Tove; Rotegard, Ann Kristin; Thorell-Ekstrand, Ingrid

    2006-01-01

    The aims of this study were to analyze the coherence between the concepts for nursing interventions in the Swedish VIPS model for nursing recording and the ISO Reference Terminology Model for Nursing Actions and to identify areas in the two models for further development. Seven Scandinavian experts analyzed the VIPS model's concepts for nursing interventions using prototypical examples of nursing actions, involving 233 units of analyses, and collaborated in mapping the two models. All nursing interventions in the VIPS model comprise actions and targets, but a few lack explicit expressions of means. In most cases, the recipient of care is implicit. Expressions for the aim of an action are absent from the ISO model. By this mapping we identified areas for future development of the VIPS model and the experience from nursing terminology work in Scandinavia can contribute to the international standardization efforts.

  12. [Standardization of activities in an oncology surgical center according to nursing intervention classification].

    PubMed

    Possari, João Francisco; Gaidzinski, Raquel Rapone; Fugulin, Fernanda Maria Togeiro; Lima, Antônio Fernandes Costa; Kurcgant, Paulina

    2013-06-01

    This study was undertaken in a surgical center specializing in oncology, and it aimed to identify nursing activities performed during the perioperative period and to classify and validate intervention activities according to the Nursing Interventions Classification (NIC). A survey of activities was conducted using records and by direct observation of nursing care across four shifts. Activities were classified as NIC nursing interventions using the cross-mapping technique. The list of interventions was validated by nursing professionals in workshops. Forty-nine interventions were identified: 34 of direct care and 15 of indirect care. Identifying nursing interventions facilitates measuring the time spent in their execution, which is a fundamental variable in the quantification and qualification of nurses' workloads.

  13. Use of the nursing intervention classification for identifying the workload of a nursing team in a surgical center.

    PubMed

    Possari, João Francisco; Gaidzinski, Raquel Rapone; Lima, Antônio Fernandes Costa; Fugulin, Fernanda Maria Togeiro; Herdman, Tracy Heather

    2015-01-01

    to analyze the distribution of nursing professionals' workloads, according to the Nursing Intervention Classification (NIC), during the transoperative period at a surgical center specializing in oncology. this was an observational and descriptive cross-sectional study. The sample consisted of 11 nurses, 25 nursing technicians who performed a variety of roles within the operating room, 16 nursing technicians who worked with the surgical instrumentation and two nursing technicians from patient reception who worked in the surgical center during the transoperative period. An instrument was developed to collect data and the interventions were validated according to NIC taxonomy. a total of 266 activities were identified and mapped into 49 nursing interventions, seven domains and 20 classes of the NIC. The most representative domains were Physiological-Complex (61.68%) and Health System (22.12%), while the most frequent interventions were Surgical Care (30.62%) and Documentation (11.47%), respectively. The productivity of the nursing team reached 95.34%. use of the Nursing Intervention Classification contributes towards the discussion regarding adequate, professional nursing staffing levels, because it shows the distribution of the work load.

  14. Basic nursing care: retrospective evaluation of communication and psychosocial interventions documented by nurses in the acute care setting.

    PubMed

    Juvé-Udina, Maria-Eulàlia; Pérez, Esperanza Zuriguel; Padrés, Núria Fabrellas; Samartino, Maribel Gonzalez; García, Marta Romero; Creus, Mònica Castellà; Batllori, Núria Vila; Calvo, Cristina Matud

    2014-01-01

    This study aimed to evaluate the frequency of psychosocial aspects of basic nursing care, as e-charted by nurses, when using an interface terminology. An observational, multicentre study was conducted in acute wards. The main outcome measure was the frequency of use of the psychosocial interventions in the electronic nursing care plans, analysed over a 12 month retrospective review. Overall, 150,494 electronic care plans were studied. Most of the intervention concepts from the interface terminology were used by registered nurses to illustrate the psychosocial aspects of fundamentals of care in the electronic care plans. The results presented help to demonstrate that the interventions of this interface terminology may be useful to inform psychosocial aspects of basic and advanced nursing care. The identification of psychosocial elements of basic nursing care in the nursing documentation may lead to obtain a deeper understanding of those caring interventions nurses consider essential to represent nurse-patient interactions. The frequency of psychosocial interventions may contribute to delineate basic and advanced nursing care. © 2013 Sigma Theta Tau International.

  15. Use of the nursing intervention classification for identifying the workload of a nursing team in a surgical center1

    PubMed Central

    Possari, João Francisco; Gaidzinski, Raquel Rapone; Lima, Antônio Fernandes Costa; Fugulin, Fernanda Maria Togeiro; Herdman, Tracy Heather

    2015-01-01

    Objective: to analyze the distribution of nursing professionals' workloads, according to the Nursing Intervention Classification (NIC), during the transoperative period at a surgical center specializing in oncology. Methods: this was an observational and descriptive cross-sectional study. The sample consisted of 11 nurses, 25 nursing technicians who performed a variety of roles within the operating room, 16 nursing technicians who worked with the surgical instrumentation and two nursing technicians from patient reception who worked in the surgical center during the transoperative period. An instrument was developed to collect data and the interventions were validated according to NIC taxonomy. Results: a total of 266 activities were identified and mapped into 49 nursing interventions, seven domains and 20 classes of the NIC. The most representative domains were Physiological-Complex (61.68%) and Health System (22.12%), while the most frequent interventions were Surgical Care (30.62%) and Documentation (11.47%), respectively. The productivity of the nursing team reached 95.34%. Conclusions: use of the Nursing Intervention Classification contributes towards the discussion regarding adequate, professional nursing staffing levels, because it shows the distribution of the work load. PMID:26487126

  16. Investigating nurse practitioners in the private sector: a theoretically informed research protocol.

    PubMed

    Adams, Margaret; Gardner, Glenn; Yates, Patsy

    2017-06-01

    To report a study protocol and the theoretical framework normalisation process theory that informs this protocol for a case study investigation of private sector nurse practitioners. Most research evaluating nurse practitioner service is focused on public, mainly acute care environments where nurse practitioner service is well established with strong structures for governance and sustainability. Conversely, there is lack of clarity in governance for emerging models in the private sector. In a climate of healthcare reform, nurse practitioner service is extending beyond the familiar public health sector. Further research is required to inform knowledge of the practice, operational framework and governance of new nurse practitioner models. The proposed research will use a multiple exploratory case study design to examine private sector nurse practitioner service. Data collection includes interviews, surveys and audits. A sequential mixed method approach to analysis of each case will be conducted. Findings from within-case analysis will lead to a meta-synthesis across all four cases to gain a holistic understanding of the cases under study, private sector nurse practitioner service. Normalisation process theory will be used to guide the research process, specifically coding and analysis of data using theory constructs and the relevant components associated with those constructs. This article provides a blueprint for the research and describes a theoretical framework, normalisation process theory in terms of its flexibility as an analytical framework. Consistent with the goals of best research practice, this study protocol will inform the research community in the field of primary health care about emerging research in this field. Publishing a study protocol ensures researcher fidelity to the analysis plan and supports research collaboration across teams. © 2016 John Wiley & Sons Ltd.

  17. [A protocol of assessment, follow-up and nutritional action at a nursing home].

    PubMed

    Abajo del Alamo, C; García Rodicio, S; Calabozo Freile, B; Ausín Pérez, L; Casado Pérez, J; Catalá Pindado, M A

    2008-01-01

    1) To assess the nutritional status of able elderly, institutionalized at a nursing home; 2) To propose the required nutritional interventions; 3) To establish a consensus protocol for nutritional assessment and follow-up at the Center. Cross-sectional study on all able residents, carrying out: 1) Mini Nutritional Assessment Test; 2) Anthropometrical assessment; 3) Biochemical assessment; and 4) an additional questionnaire (gathering information on dental prostheses, swallowing difficulties, and special diets or oral supplements). Analysis of these data to implement appropriate recommendations and elaborating a nutritional protocol. The mean age of the 50 residents assessed was 84 years [66-97], mean weight 62 kg [35-87], mean height 154 cm [140-175], mean body mass index 26 [15.6-36], mean tricipital fold 18.1 mm [4-36], and mean muscle arm circumference 20.6 cm [14.7-27.1]. By using the Mini Nutritional Assessment Test we identified 3/50 (6% [95% CI: 1-16]) malnourished residents, and 6/50 (12% [95% CI: 4-24]) residents at risk for malnourishment. The body mass index allowed to identify 11/50 (22% [95% CI: 11-35]) overweighed residents-body mass index 27-29-, 10/50 (20% [95% CI: 10-33]) with grade I obesity -body mass index 30-35 and 1/50 (2% [95% CI: 0-10]) with grade II obesity-body mass index > 35-. None of them presented values below the 5th percentile for both the tricipital fold and the muscle arm circumference. Values above the 95th percentile were found in 10/50 (20% [95% CI: 10-33]) residents for the tricipital fold and in 7/50 (14% [95% CI: 5-26]) for the muscle arm circumference, both criteria being present in 3 residents. In all of them the body mass index mayor was > 27. When analyzing the biochemical parameters, the results were not concordant, since laboratory workups analyzed were not always done at the same time as the interview. After analyzing the data obtained, a nutritional assessment and follow-up protocol was elaborated in collaboration

  18. Using nursing intervention classification in an advance practice registered nurse-led preventive model for adults aging with developmental disabilities.

    PubMed

    Hahn, Joan Earle

    2014-09-01

    To describe the most frequently reported and the most central nursing interventions in an advance practice registered nurse (APRN)-led in-home preventive intervention model for adults aging with developmental disabilities using the Nursing Intervention Classification (NIC) system. A descriptive data analysis and a market basket analysis were conducted on de-identified nominal nursing intervention data from two home visits conducted by nurse practitioners (NPs) from October 2010 to June 2012 for 80 community-dwelling adults with developmental disabilities, ages 29 to 68 years. The mean number of NIC interventions was 4.7 in the first visit and 6.0 in the second visit and last visit. NPs reported 45 different intervention types as classified using a standardized language, with 376 in Visit One and 470 in Visit Two. Approximately 85% of the sample received the Health education intervention. The market basket analysis revealed common pairs, triples, and quadruple sets of interventions in this preventive model. The NIC nursing interventions that occurred together repeatedly were: Health education, Weight management, Nutrition management, Health screening, and Behavior management. Five NIC interventions form the basis of an APRN-led preventive intervention model for individuals aging with lifelong disability, with health education as the most common intervention, combined with interventions to manage weight and nutrition, promote healthy behaviors, and encourage routine health screening. Less frequently reported NIC interventions suggest the need to tailor prevention to individual needs, whether acute or chronic. APRNs employing prevention among adults aging with developmental disabilities must anticipate the need to focus on health education strategies for health promotion and prevention as well as tailor and target a patient-centered approach to support self-management of health to promote healthy aging in place. These NIC interventions serve not only as a guide for

  19. A Standardized Nursing Intervention Protocol for HCT Patients

    ClinicalTrials.gov

    2015-06-03

    Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Neoplasms; Psychosocial Effects of Cancer and Its Treatment; Therapy-related Toxicity

  20. A literature review of conflict communication causes, costs, benefits and interventions in nursing.

    PubMed

    Brinkert, Ross

    2010-03-01

    This paper reviews the literature on conflict communication in nursing in order to prioritize research, theory and interventions that will support nurse managers and staff nurses. Conflict is pervasive in nursing and has many costs, including burnout, higher absenteeism and higher turnover. Increased and more effective use of conflict management seems important in sustaining and developing the field. The literature study focused on the intersection of nursing, communication and conflict. The review primarily drew from the nursing and communication disciplines. While much is known about the sources and costs of conflict in nursing, more can be done to research the benefits of conflict and intervene effectively. Conflict is a routine feature of nursing. Nonetheless, sources can be managed, costs decreased and benefits increased with indirect and direct interventions. Nurse managers can support themselves and others in working through conflict by normalizing conflict, employing proven proactive and reactive interventions and by helping to build integrated conflict management systems.

  1. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol.

    PubMed

    Furberg, Robert D; Ortiz, Alexa M; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

    2016-06-27

    Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care-related infections were reviewed to develop the infection control protocol to support tablet maintenance. This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings.

  2. [Consensus on nursing diagnoses, interventions and outcomes for home care of patients with heart failure].

    PubMed

    Azzolin, Karina; de Souza, Emiliane Nogueira; Ruschel, Karen Brasil; Mussi, Cláudia Motta; de Lucena, Amália Fátima; Rabelo, Eneida Rejane

    2012-12-01

    This was a consensus study with six cardiology nurses with the objective of selecting nursing diagnoses, outcomes and interventions described by NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), Nursing Intervention Classification (NIC), for home care of patients with heart failure (HF). Eight nursing diagnoses (NDs) were pre-selected and a consensus was achieved in three stages, during which interventions/activities and outcomes/indicators of each NDs were validated and those considered valid obtained 70% to 100% consensus. From the eight pre-selected NDs, two were excluded due to the lack of consensus on appropriate interventions for the clinical home care scenario. Eleven interventions were selected from a total of 96 pre-selected ones and seven outcomes were validated out of 71. The practice of consensus among expert nurses provides assistance to the qualifications of the care process and deepens the knowledge about the use of tazonomies in nursing clinical practice.

  3. Depression in the older adult: recognition and nursing intervention.

    PubMed

    Mynatt, Sarah L

    2004-01-01

    The importance of identifying and intervening in elders with depression cannot be underestimated. The baby boom population is reaching the chronological milestone of being considered older age, which means that the percentage of older adults with depression will result in increased numbers of depressed older adults in all settings needing nursing care. Nurses must be able to recognize symptoms of depression, whether subsyndromal depression or major depression, to be able to intervene effectively. Depressive symptoms interfere with the quality of life and respond to nursing interventions that address psychosocial functioning including loss, educational strategies to increase understanding of depression as a disease, its treatment and adherence strategies, interventions that monitor and improve chronic medical illness, and recognize medication management that has the least likelihood of side effects. The importance of psychotherapies was not stressed above due to limitations in space, but in addition to problem solving therapy, cognitive and interpersonal supportive therapies are also effective. Electroconvulsive therapy is also effective in treating depression in the elderly when the patient is suicidal.

  4. [Nursing care in patients undergoing interventional neuroendovascular procedures].

    PubMed

    Galimany-Masclans, Jordi; Garcia-Sort, Rosa; Pernas-Canadell, Juan Carlos

    2009-01-01

    Vascular interventional radiology (VIR) procedures have increased markedly, partly due to the current healthcare context, which encourages the use of less invasive procedures that reduce pressure on surgery departments and decrease hospital stays. In most patients, these techniques can be carried out in a single intervention. VIR procedures are based on the possibility of gaining access to vascular structures through a catheter inserted percutaneously without the need for open surgery. Due to the complexity of these procedures, hospitalization is required before and after the technique is performed but length of stay is short compared with that associated with surgery. As the health workers closest to patients, nurses must respond to their information needs. The provision of comprehensive nursing care should include all the care required before, during and after the procedure and all aspects related to the quality of the healthcare process. Knowledge of how diagnostic and therapeutic VIR techniques are performed in the neurovascular section is essential. Based on the authors' experience, the present article aims to provide nurses with knowledge of some neurointerventional procedures (cerebral angiography and embolization of intracranial aneurysms) and of the care provided in RVI rooms.

  5. Comparison of Indirect Nursing Interventions Performed by Korean and U.S. Nurses Using the Nursing Interventions Classification (NIC) System.

    PubMed

    Lee, Eunjoo; Park, Hyejin

    2016-07-01

    The purposes of this study were to identify frequency and time spent performing indirect nursing interventions by Korean nurses, and to compare the time spent on indirect nursing interventions with estimates of time spent by U.S. nurses. Data were collected from 721 registered nurses working in eight hospitals in Korea. U.S. data were obtained from the fifth edition of the Nursing Interventions Classification published in 2008. Korean nurses took more time with 4 interventions, and U.S. nurses took more time with 13. In general, Korean nurses spent less time performing indirect interventions than did U.S. nurses. Information from this study will help nurse administrators in their decision-making processes regarding managing units and staffing. © 2015 NANDA International, Inc.

  6. Systematic review of interdisciplinary interventions in nursing homes.

    PubMed

    Nazir, Arif; Unroe, Kathleen; Tegeler, Monica; Khan, Babar; Azar, Jose; Boustani, Malaz

    2013-07-01

    The role of interdisciplinary interventions in the nursing home (NH) setting remains unclear. We conducted a systematic evidence review to study the benefits of interdisciplinary interventions on outcomes of NH residents. We also examined the interdisciplinary features of successful trials, including those that used formal teams. Medline was searched from January 1990 to August 2011. Search terms included residential facilities, long term care, clinical trial, epidemiologic studies, epidemiologic research design, comparative study, evaluation studies, meta-analysis and guideline. We included randomized controlled trials (RCTs) evaluating the efficacy of interdisciplinary interventions conducted in the NH setting. We used the Cochrane Collaboration tools to appraise each RCT, and an RCT was considered positive if its selected intervention had a significant positive effect on the primary outcome regardless of its effect on any secondary outcome. We also extracted data from each trial regarding the participating disciplines; for trials that used teams, we studied the reporting of various team elements, including leadership, communication, coordination, and conflict resolution. We identified 27 RCTs: 7 had no statistically significant effect on the targeted primary outcome, 2 had a statistically negative effect, and 18 demonstrated a statistically positive effect. Participation of residents' own primary physicians (all 6 trials were positive) and/or a pharmacist (all 4 trials were positive) in the intervention were common elements of successful trials. For interventions that used formal team meetings, presence of communication and coordination among team members were the most commonly observed elements. Overall interdisciplinary interventions had a positive impact on resident outcomes in the NH setting. Participation of the residents' primary physician and/or a pharmacist in the intervention, as well as team communication and coordination, were consistent features of

  7. Spiritual Care Intervention and Spiritual Well-Being: Jordanian Muslim Nurses' Perspectives.

    PubMed

    Musa, Ahmad S

    2016-04-22

    This study explored the frequency of providing aspects of spiritual care intervention and its association with nurses' own spiritual well-being in a convenience sample of 355 Jordanian Arab Muslim nurses. The nurses were recruited from different hospitals, representing both public and private health care sectors in northern and central Jordan. A cross-sectional descriptive and correlational design was used. Results indicated that Jordanian Muslim nurses provided religious aspects of spiritual care intervention to their Muslim patients infrequently and that their own spiritual well-being was positively associated with the frequency of provision of spiritual care interventions. The study concluded that Jordanian Muslim nurses most frequently provided spiritual care interventions that were existential, not overtly religious, were commonly used, were more traditional, and did not require direct nurse involvement. Moreover, the findings revealed that spiritual well-being was important to those nurses, which has implications for improving the provision of spiritual care intervention. The study provides information that enables nurses, nursing managers, and nursing educators to evaluate the nurses' provision of various aspects of spiritual care to their Muslim patients, and to identify aspects of spiritual care intervention where nurses might receive training to become competent in providing this care.

  8. Margaret Newman's Theory of Health as Expanding Consciousness and a Nursing Intervention from a Unitary Perspective

    PubMed Central

    Endo, Emiko

    2017-01-01

    This mini-review aims to introduce Margaret Newman's theory of health as expanding consciousness and caring partnership as a nursing intervention. Emanating from a unitary and transformative perspective of nursing, caring partnership enables nurses to identify with cancer patients as well as to help the patients find meaning in their situation and their lives. In genuine patient–nurse interactions, both patients and nurses experience higher levels of consciousness. PMID:28217730

  9. Patient and nurse preferences for nurse handover—using preferences to inform policy: a discrete choice experiment protocol

    PubMed Central

    Spinks, Jean; Chaboyer, Wendy; Bucknall, Tracey; Tobiano, Georgia; Whitty, Jennifer A

    2015-01-01

    Introduction Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. Methods and analysis We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. Ethics and dissemination This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences. PMID:26560060

  10. [The intervention mapping protocol: A structured process to develop, implement and evaluate health promotion programs].

    PubMed

    Fassier, J-B; Lamort-Bouché, M; Sarnin, P; Durif-Bruckert, C; Péron, J; Letrilliart, L; Durand, M-J

    2016-02-01

    Health promotion programs are expected to improve population health and reduce social inequalities in health. However, their theoretical foundations are frequently ill-defined, and their implementation faces many obstacles. The aim of this article is to describe the intervention mapping protocol in health promotion programs planning, used recently in several countries. The challenges of planning health promotion programs are presented, and the six steps of the intervention mapping protocol are described with an example. Based on a literature review, the use of this protocol, its requirements and potential limitations are discussed. The intervention mapping protocol has four essential characteristics: an ecological perspective (person-environment), a participative approach, the use of theoretical models in human and social sciences and the use of scientific evidence. It comprises six steps: conduct a health needs assessment, define change objectives, select theory-based change techniques and practical applications, organize techniques and applications into an intervention program (logic model), plan for program adoption, implementation, and sustainability, and generate an evaluation plan. This protocol was used in different countries and domains such as obesity, tobacco, physical activity, cancer and occupational health. Although its utilization requires resources and a critical stance, this protocol was used to develop interventions which efficacy was demonstrated. The intervention mapping protocol is an integrated process that fits the scientific and practical challenges of health promotion. It could be tested in France as it was used in other countries, in particular to reduce social inequalities in health. Copyright © 2016. Published by Elsevier Masson SAS.

  11. How nursing leadership and management interventions could facilitate the effective use of ICT by student nurses.

    PubMed

    Willmer, Marian

    2007-03-01

    . These reasons include lack of time for Information and Communications Technology activities by both students and the qualified nurses and some staff with poor Information and Communications Technology skills. This situation is compounded by insufficient computer hardware; lack of information about the essence and value of Information and Communications Technology; perception of the direct relevance of Information and Communications Technology activities to patient care; software materials not adequate for purpose and lack of comprehensive budget and financial recognition for student's engagement with Information and Communications Technology. 'Smile and the whole world smile with you'. This old saying has a lot of truth in it. Applied to Information and Communications Technology skills development and use by student nurses we are confronted with an uncomfortable reality of many qualified nurses who themselves are not comfortable or proficient with the use of Information and Communications Technology. Some do not see the essential need for Information and Communications Technology and its direct relevance to improving patient care, nor is this always supported by the current software and systems. Willmer argued that the achievement of effective implementation of the National Health Service National Programme for Information and Technology requires efficient change management and leading people skills, and an understanding of National Health Service culture. In this article the case is made that evidence-based management and leadership interventions are a feasible approach for a sustained implementation of Information and Communications Technology use and skills development by student nurses.

  12. Nursing home applications--reasons and possible interventions.

    PubMed

    Chan, K M; Wong, S F; Yoong, T

    1998-10-01

    With a rapidly ageing population like Singapore, the need for nursing homes will increase. Admission to a nursing home may be for medical and/or social reasons. We carried out case studies with the Care Liaison Service (CLS) of the Ministry of Health to determine reasons why the elderly applied for nursing home admission, and whether it was possible to prevent an admission. During the 6-month study period, 331 applications were received, of which 280 (84.6%) were > or = 60 years. There was an equal distribution of male (50.4%) and female (49.6%) applicants. Applicants were predominantly Chinese (86.0%), followed by Indians (8.0%), Malays and other races (3.0% each). Most of the applicants were semi-ambulant (50.0%), fully ambulant (31.4%) and non-ambulant (18.6%). The most common medical problems of the applicants were neurological (e.g. stroke, normal pressure hydrocephalus, epilepsy), heart diseases (e.g. hypertension, ischaemic heart disease, heart failure), orthopaedic conditions (e.g. osteoarthritis, fractures neck of femur and other fractures), and psychiatric problems (e.g. dementia, depression and history of schizophrenia/paranoid psychosis). Fifty-seven applicants (20.4%) were selected for intervention. They were 'non-psychiatric' patients whose caregivers were willing but unable to look after them. About half (28, 49.1%) of these applicants required nursing home care. The remaining 29 patients (50.9%) had the potential of improving or able to remain at home with appropriate community services. These 29 patients were contacted by the CLS nurse and the following recommendations were made: 1) inpatient rehabilitation in a community hospital (7 patients); 2) rehabilitation and day care in a community-based day care centre (17 patients); 3) domiciliary medical care (4 patients), and 4) reassessment by psychiatrist to control psychotic symptoms (1 patient). Only 6 patients were willing to accept the new recommendations. This poor result may imply that attempts

  13. Impact of acceptance-based nursing intervention on postsurgical recovery: preliminary findings.

    PubMed

    Fernández, María Dolores; Luciano, Carmen; Valdivia-Salas, Sonsoles

    2012-11-01

    Research has shown that teaching individuals to experience pain and anxiety as inevitable products of the actions they freely and responsibly undertake yields healthier reactions to suffering. This preliminary study assesses whether a brief acceptance-based psychological intervention along with the usual presurgical protocol for a laparoscopic cholecystectomy will produce healthier reactions to postsurgical pain, and will reduce anxiety, duration of postsurgical hospitalization, and demand of analgesics. After admission, screening, and consent procedures, we assessed pain and anxiety. Patients in the experimental condition (n = 6) then received a brief acceptance-based nursing intervention addressing the individual meaning of surgery, and including a metaphor and defusion practice, along with routine care. Patients in the control condition (n = 7) received routine care only. Twenty-four hr following the intervention, surgery took place. Pain, anxiety, and patients' demand for analgesics were assessed 24 hr or 48 hr after surgery. All six experimental patients, as compared to three of seven control patients, demanded fewer analgesics and left the hospital within 24 hr or 48 hr from surgery even in the presence of frequent and/or intense pain. Anxiety slightly decreased in the experimental patients. The brief acceptance-based intervention was effective in improving postsurgical recovery. These preliminary findings support the potential of this type of intervention as a cost-effective strategy to be implemented in the sanitary context.

  14. Additional considerations are required when preparing a protocol for a systematic review with multiple interventions.

    PubMed

    Chaimani, Anna; Caldwell, Deborah M; Li, Tianjing; Higgins, Julian P T; Salanti, Georgia

    2017-03-01

    The number of systematic reviews that aim to compare multiple interventions using network meta-analysis is increasing. In this study, we highlight aspects of a standard systematic review protocol that may need modification when multiple interventions are to be compared. We take the protocol format suggested by Cochrane for a standard systematic review as our reference and compare the considerations for a pairwise review with those required for a valid comparison of multiple interventions. We suggest new sections for protocols of systematic reviews including network meta-analyses with a focus on how to evaluate their assumptions. We provide example text from published protocols to exemplify the considerations. Standard systematic review protocols for pairwise meta-analyses need extensions to accommodate the increased complexity of network meta-analysis. Our suggested modifications are widely applicable to both Cochrane and non-Cochrane systematic reviews involving network meta-analyses. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. [Virtual environment: assistance in nursing care for the deaf based on the protocol of primary care].

    PubMed

    Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa

    2014-08-01

    Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations. An experimental study applied by two nurses and a nurse manager, in a sample of 30 deaf patients aged between 30 and 60 years. The environment was built in Visual Basic NET and offered eight screens about feeding containing food pictures, videos in Libras (Brazilian sign language) and audio. The analysis of the VE was done through questionnaires applied to patients and professionals by the Poisson statistical test. The VE shows the possible diagnostics in red, yellow, green and blue colors, depending on the degree of patients' need. The environment obtained excellent acceptance by patients and nurses, allowing great interaction between them, even without an interpreter. The time in consultation was reduced to 15 minutes, with the preservation of patient privacy.

  16. Nursing interventions in managing wandering behavior in patients with dementia: a literature review.

    PubMed

    Gu, Lin

    2015-12-01

    Wandering behavior is common in patients with dementia. The purpose of this literature review was to define wandering, describe the factors of wandering and analyze different interventions and nursing skill of managing this behavior. Finally, barriers to and effective nursing intervention for wandering behavior will be reviewed as they appear within the literature. The search was conducted to use the PubMed, ProQuest, CINAHL, MEDLINE databases from 1990 to 2015. Search terms used included 'wandering', 'intervention', 'dementia or Alzheimer', 'nursing', and 'elopement'. The inclusion criteria were: implementing the effective nursing intervention to manage wandering behavior, scholarly and peer reviewed journals, and publication in the English language.

  17. Screening, brief intervention, and referral to treatment (SBIRT) as an integral part of nursing practice.

    PubMed

    Finnell, Deborah S; Nowzari, Shahrzad; Reimann, Brie; Fischer, Leigh; Pace, Elizabeth; Goplerud, Eric

    2014-01-01

    ABSTRACT. Substance use screening, brief intervention, and referral to treatment (SBIRT) should be an integral part of the scope of nursing practice. This commentary is an appeal for nurses to advance their knowledge and competencies related to SBIRT. The question of how to move SBIRT into the mainstream of nursing practice was posed to several leaders of federal agencies, health care and nursing organizations, nurse educators, and nurse leaders. The authors provide recommendations for moving this set of clinical strategies (i.e., SBIRT) into day-to-day nursing practice.

  18. The nature of telephone nursing interventions in a heart failure clinic setting.

    PubMed

    Staples, Patti; Earle, Wendy

    2008-01-01

    There is a lack of published data about the nature of nursing interventions that are required to provide telephone management for patients with heart failure (HF). The nature of patient issues, telephone nursing interventions, and associated workload at one HF clinic are described in this study. Workload was captured using a computerized workload measurement tool. An electronic telephone log categorizing nursing interventions as providing education, changing medication doses, ordering diagnostic tests and consulting with community health care providers, and the scope of practice required to complete the intervention was kept. Nurses spent 24% of their working hours doing 1914 telephone visits in one year. Medications were changed 583 times and diagnostic tests were ordered 207 times. Nurses initiated 65% of calls; others were received from patients, family members, and other health care providers. A combination of nurse practitioners and registered nurses with medical directives can address the issues that commonly arise through telephone management of HF patients.

  19. Randomized controlled trial of the effectiveness of an intervention to implement evidence-based patient decision support in a nursing call centre.

    PubMed

    Stacey, Dawn; O'Connor, Annette M; Graham, Ian D; Pomey, Marie-Pascale

    2006-01-01

    We evaluated the effect of an intervention on call centre nurses' knowledge of decision support and skills in coaching callers facing value-sensitive health decisions. Forty-one registered nurses at a health call centre were randomly assigned to an intervention or control group. The intervention was a coaching protocol, online tutorial, skills building workshop and performance feedback. The main outcome measures were: knowledge test; blinded quality assessment of coaching skills during simulated calls and call duration. Compared with controls, nurses in the intervention group had better knowledge (74 versus 60%, P = 0.007) and decision coaching skills (81 versus 44%, P < 0.001), particularly in assessing decisional needs (information, values clarity, support, stage and timing of decision) and addressing support issues. Call duration did not differ (18.5 versus 16.7 min, P = 0.73). The coaching protocol was rated as compatible with nurses' views on decision-making and more advantageous compared with their usual practices. The intervention improved the quality of nurses' decision coaching without affecting call duration.

  20. [Interventional Patient Hygiene Model. A critical reflection on basic nursing care in intensive care units].

    PubMed

    Bambi, Stefano; Lucchini, Alberto; Solaro, Massimo; Lumini, Enrico; Rasero, Laura

    2014-01-01

    Interventional Patient Hygiene Model. A critical reflection on basic nursing care in intensive care units. Over the past 15 years, the model of medical and nursing care changed from being exclusively oriented to the diagnosis and treatment of acute illness, to the achievement of outcomes by preventing iatrogenic complications (Hospital Acquired Conditions). Nursing Sensitive Outcomes show as nursing is directly involved in the development and prevention of these complications. Many of these complications, including falls from the bed, use of restraints, urinary catheter associated urinary infections and intravascular catheter related sepsis, are related to basic nursing care. Ten years ago in critical care, a school of thought called get back to the basics, was started for the prevention of errors and risks associated with nursing. Most of these nursing practices involve hygiene and mobilization. On the basis of these reflections, Kathleen Vollman developed a model of nursing care in critical care area, defined Interventional Patient Hygiene (IPH). The IPH model provides a proactive plan of nursing interventions to strengthen the patients' through the Evidence-Based Nursing Care. The components of the model include interventions of oral hygiene, mobilization, dressing changes, urinary catheter care, management of incontinence and bed bath, hand hygiene and skin antisepsis. The implementation of IPH model follows the steps of Deming cycle, and requires a deep reflection on the priorities of nursing care in ICU, as well as the effective teaching of the importance of the basic nursing to new generations of nurses.

  1. Evaluating Sexual Nursing Care Intervention for Reducing Sexual Dysfunction in Indonesian Cervical Cancer Survivors

    PubMed Central

    Afiyanti, Yati; Rachmawati, Imami Nur; Milanti, Ariesta

    2016-01-01

    Objective: This study aims to describe the factors affecting successful nursing care intervention on sexuality. Methods: A one-group pre- and post-test design was used. Fifty-three cervical cancer survivors and their spouses were administered with nursing care intervention on sexuality in three sessions and evaluated after 6 weeks. Results: Sexual intervention reduced dyspareunia symptoms, improved vaginal lubrication, improved sexual satisfaction, and enhanced sexual arousal, sexual desire, and orgasm among cancer survivors and their spouses. The other influencing factors also simultaneously contributed to the success of nursing care intervention. Conclusions: Nursing care intervention on sexuality could be a part of supportive nursing care and an important aspect in standard nursing care for cancer patients in Indonesia. PMID:27981170

  2. An intervention to enhance nursing staff teamwork and engagement.

    PubMed

    Kalisch, Beatrice J; Curley, Millie; Stefanov, Susan

    2007-02-01

    Numerous studies have concluded that work group teamwork leads to higher staff job satisfaction, increased patient safety, improved quality of care, and greater patient satisfaction. Although there have been studies on the impact of multidisciplinary teamwork in healthcare, the teamwork among nursing staff on a patient care unit has received very little attention from researchers. In this study, an intervention to enhance teamwork and staff engagement was tested on a medical unit in an acute care hospital. The results showed that the intervention resulted in a significantly lower patient fall rate, staff ratings of improved teamwork on the unit, and lower staff turnover and vacancy rates. Patient satisfaction ratings approached, but did not reach, statistical significance.

  3. Impacts of information and communication technologies on nursing care: an overview of systematic reviews (protocol).

    PubMed

    Rouleau, Geneviève; Gagnon, Marie-Pierre; Côté, José

    2015-05-23

    Information and communication technologies (ICTs) used in the health sector have well-known advantages. They can promote patient-centered healthcare, improve quality of care, and educate health professionals and patients. However, implementation of ICTs remains difficult and involves changes at different levels: patients, healthcare providers, and healthcare organizations. Nurses constitute the largest health provider group of the healthcare workforce. The use of ICTs by nurses can have impacts in their practice. The main objective of this review of systematic reviews is to systematically summarize the best evidence regarding the effects of ICTs on nursing care. We will include all types of reviews that aim to evaluate the influence of ICTs used by nurses on nursing care. We will consider four types of ICTs used by nurses as a way to provide healthcare: management systems, communication systems, information systems, and computerized decision support systems. We will exclude nursing management systems, educational systems, and telephone systems. The following types of comparisons will be carried out: ICT in comparison with usual care/practice, ICT compared to any other ICT, and ICT versus other types of interventions. The primary outcomes will include nurses' practice environment, nursing processes/scope of nursing practice, nurses' professional satisfaction as well as nursing sensitive outcomes, such as patient safety, comfort, and quality of life related to care, empowerment, functional status, satisfaction, and patient experience. Secondary outcomes will include satisfaction with ICT from the nurses and patients' perspective. Reviews published in English, French, or Spanish from 1 January 1995 will be considered. Two reviewers will independently screen the title and abstract of the papers in order to assess their eligibility and extract the following information: characteristics of the population and setting, type of interventions (e.g., type of ICTs and service

  4. Stagnant perceptions of nursing among high school students: results of a shadowing intervention study.

    PubMed

    Porter, Gloria; Edwards, Pamela B; Granger, Bradi B

    2009-01-01

    To gain insight into high school students' perceptions of the role of the nurse and to explore students' impressions of nursing following a nurse-shadowing intervention. Often nurses abandon staffing positions in the first 1-2 years, reporting a "poor fit" with nursing. Few studies have examined expectations and perceptions of nursing among high school students; a population of potential nurses in whom a more accurate view of nursing opportunities and professionalism may be fostered. High school students from two North Carolina counties participated in a nurse-shadowing intervention. Constant comparison and thematic coding were used for analysis of post-intervention in-depth interviews. Sixteen of 24 students completed the study. Misperception of nursing was the dominant theme. Five sub-themes were professional role responsibility, teamwork, caring relationships, tools and technology, and medication management. Experiential knowledge of nursing was a core need for students interested in nursing careers. These data suggest that a nurse shadowing program may positively influence perceptions of nursing, and may result in improved recruitment and retention in the workplace.

  5. Patients' descriptions of nursing interventions supporting quality of life in acute psychiatric wards: a qualitative study.

    PubMed

    Pitkänen, Anneli; Hätönen, Heli; Kuosmanen, Lauri; Välimäki, Maritta

    2008-11-01

    People with mental disorders suffer from impaired quality of life (QoL). In psychiatric hospital wards nurses are in a close relationship with patients and have good opportunities to support patients' QoL. Still, relatively little is known about patients' perceptions related to nursing interventions by which nurses can support the QoL of patients with severe mental illness. To explore patients' perceptions of nursing interventions in supporting patients' QoL in acute psychiatric inpatient settings. Explorative descriptive study design. The study was conducted in seven acute 24-h psychiatric wards of general hospitals in Southern Finland. Thirty-five inpatients diagnosed with schizophrenia, schizotypal disorder or delusional disorder. The data were generated through semi-structured interviews and processed by means of qualitative content analysis. Five main categories of patients' perceptions of nursing interventions were identified to support QoL from patients' descriptions: empowering interventions, social interventions, activating interventions, security interventions and interventions to support physical health. Impaired QoL of patients with severe mental illness can be supported in acute psychiatric wards through nursing interventions. However, we are not sure how effective these interventions are. Thus, research on the effectiveness of nursing interventions to support patients' QoL is needed.

  6. Computer Aided Instruction/Management of Nursing Protocols, Continuing Education and Patient Education for Remote Delivery

    PubMed Central

    Masten, Yondell; Conover, Katherine P.

    1988-01-01

    Utilization of computer networks to provide instruction for health care providers and patients can increase knowledge for the participants and reduce the disadvantages of current methods of instruction, i.e., sporadic, inconsistent, hurried instruction patterns. Nursing protocols and nursing and patient education modules were developed as components of KARENET (Kellogg Affiliated Remote Environments Network), linking rural Morton, Texas, and the Health Sciences Center at Lubbock. Both health care providers and patient participants benefit from utilization of knowledge provided by the methodology of CAI/CMI.

  7. Nursing interventions for rehabilitation in Parkinson's disease: cross mapping of terms

    PubMed Central

    Tosin, Michelle Hyczy de Siqueira; Campos, Débora Moraes; de Andrade, Leonardo Tadeu; de Oliveira, Beatriz Guitton Renaud Baptista; Santana, Rosimere Ferreira

    2016-01-01

    ABSTRACT Objective: to perform a cross-term mapping of nursing language in the patient record with the Nursing Interventions Classification system, in rehabilitation patients with Parkinson's disease. Method: a documentary research study to perform cross mapping. A probabilistic, simple random sample composed of 67 records of patients with Parkinson's disease who participated in a rehabilitation program, between March of 2009 and April of 2013. The research was conducted in three stages, in which the nursing terms were mapped to natural language and crossed with the Nursing Interventions Classification. Results: a total of 1,077 standard interventions that, after crossing with the taxonomy and refinement performed by the experts, resulted in 32 interventions equivalent to the Nursing Interventions Classification (NIC) system. The NICs, "Education: The process of the disease.", "Contract with the patient", and "Facilitation of Learning" were present in 100% of the records. For these interventions, 40 activities were described, representing 13 activities by intervention. Conclusion: the cross mapping allowed for the identification of corresponding terms with the nursing interventions used every day in rehabilitation nursing, and compared them to the Nursing Interventions Classification. PMID:27508903

  8. Physical rehabilitation interventions for adult patients with critical illness across the continuum of recovery: an overview of systematic reviews protocol.

    PubMed

    Connolly, Bronwen; O'Neill, Brenda; Salisbury, Lisa; McDowell, Kathryn; Blackwood, Bronagh

    2015-09-29

    Patients admitted to the intensive care unit with critical illness often experience significant physical impairments, which typically persist for many years following resolution of the original illness. Physical rehabilitation interventions that enhance restoration of physical function have been evaluated across the continuum of recovery following critical illness including within the intensive care unit, following discharge to the ward and beyond hospital discharge. Multiple systematic reviews have been published appraising the expanding evidence investigating these physical rehabilitation interventions, although there appears to be variability in review methodology and quality. We aim to conduct an overview of existing systematic reviews of physical rehabilitation interventions for adult intensive care patients across the continuum of recovery. This protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. We will search the Cochrane Systematic Review Database, Database of Abstracts of Reviews of Effectiveness, Cochrane Central Register of Controlled Trials, MEDLINE, Excerpta Medica Database and Cumulative Index to Nursing and Allied Health Literature databases. We will include systematic reviews of randomised controlled trials of adult patients, admitted to the intensive care unit and who have received physical rehabilitation interventions at any time point during their recovery. Data extraction will include systematic review aims and rationale, study types, populations, interventions, comparators, outcomes and quality appraisal method. Primary outcomes of interest will focus on findings reflecting recovery of physical function. Quality of reporting and methodological quality will be appraised using the PRISMA checklist and the Assessment of Multiple Systematic Reviews tool. We anticipate the findings from this novel overview of systematic reviews will contribute to the

  9. Validating the 'intervention wheel' in the context of Irish public health nursing.

    PubMed

    McDonald, Anne; Frazer, Kate; Duignan, Catriona; Healy, Marianne; Irving, Annette; Marteinsson, Patricia; Molloy, Brenda; McNicholas, Elizabeth

    2015-03-01

    Illuminating the full range of nursing actions is a challenge for nurses globally; the invisibility of nursing and of public health nursing in particular is well documented. Visibility can be enhanced by identifying core functions of nursing and matching corresponding levels of interventions and outcomes. This is a priority for the contemporary Irish public health nursing (PHN) service. In the United States, public health nurses have developed an 'Intervention Wheel' naming public health interventions at community, systems and individual/family levels. This aimed to make visible the core functions of PHN practice. The values and beliefs underpinning the Intervention Wheel have been shown to capture the essence of public health nursing within the European context. In total, US nurses described 17 Wheel interventions by recording stories from practice. Owing to concern that the public health aspect of their role was not only invisible but was at risk of erosion, Irish PHNs decided to replicate this storytelling approach to provide evidence for and authenticate the 17 interventions on the Intervention Wheel from their day-to-day public health practice.

  10. Behavior Intervention for Students with Externalizing Behavior Problems: Primary-Level Standard Protocol

    ERIC Educational Resources Information Center

    Benner, Gregory J.; Nelson, J. Ron; Sanders, Elizabeth A.; Ralston, Nicole C.

    2012-01-01

    This article examined the efficacy of a primary-level, standard-protocol behavior intervention for students with externalizing behavioral disorders. Elementary schools were randomly assigned to treatment (behavior intervention) or control (business as usual) conditions, and K-3 students were screened for externalizing behavior risk status. The…

  11. Preservice Interdisciplinary Preparation of Early Intervention Specialists in a College of Nursing: Faculty Reflections and Recommendations.

    ERIC Educational Resources Information Center

    Godfrey, Athleen B.

    1995-01-01

    This article relates experiences and insights gained by a nurse educator directing the University of Utah College of Nursing's Utah Early Intervention Personnel Preparation project, a graduate-level interdisciplinary program to prepare early intervention specialists. Recommendations are offered for development of preservice or inservice…

  12. Telephone interventions for family caregivers of patients with dementia: what are best nursing practices?

    PubMed

    Mason, Bernadette J; Harrison, Barbara E

    2008-01-01

    Family caregivers of patients with dementia experience caregiver burden and need holistic nursing interventions, such as telephone support. This article reviews the literature on telephone support interventions for family caregivers of patients with dementia and describes evidence-based holistic nursing practices within Watson's theory of human caring, which focuses on transpersonal caring relationships.

  13. Empowering frontline nurses: a structured intervention enables nurses to improve medication administration accuracy.

    PubMed

    Kliger, Julie; Blegen, Mary A; Gootee, Dave; O'Neil, Edward

    2009-12-01

    Seven hospitals from the San Francisco Bay Area participated in an 18-month-long Integrated Nurse Leadership Program, which was designed to improve the reliability of medication administration by developing and deploying nurse leadership and process improvement skills on one medical/surgical inpatient unit. Each hospital formed a nurse-led project team that worked on six safety processes to improve the accuracy of medication administration: Compare medication to the medication administration record, keep medication labeled from preparation to administration, check two forms of patient identification, explain drug to patient (if applicable), chart immediately after administration, and protect process from distractions and interruptions. For the six hospitals included in the analysis, the accuracy of medication administration (as measured by the percent of correct doses administered) improved from 85% in the baseline period to 92% six months after the intervention and 96% 18 months after the intervention. The sum of the six safety processes completed also improved significantly, from 4.8 on a 0-6 scale at baseline to 5.6 at 6 months to 5.75 at 18 months. This study suggests that frontline nurses and other hospital-based staff, if given the training, resources, and authority, are well positioned to improve patient care and safety processes on hospital patient units. Frontline clinicians have the unique opportunity to see what is and is not working in the direct provision of patient care. To address the sustainability of the program's changes after the official project ended, each team was required to develop a sustainability plan entailing monitoring of progress, actions to ensure the improvements are built into the organizational infrastructure, and staff's interaction with leaders to ensure that the work could continue.

  14. Train-the-trainer intervention to increase nursing teamwork and decrease missed nursing care in acute care patient units.

    PubMed

    Kalisch, Beatrice J; Xie, Boqin; Ronis, David L

    2013-01-01

    Teamwork is essential for patient safety and results in less missed nursing care. The aim of this study was to test the impact of a train-the-trainer intervention on the level of satisfaction with nursing teamwork and the amount of missed nursing care. This study used a quasiexperimental design with repeated measures taken at pretest, posttest, and 2 months after completion of the intervention. The sample for this study was the nursing staff on three medical-surgical units in three separate acute care hospitals (one unit in each hospital). Three nurses from each unit underwent a training program and then taught the skills and knowledge they acquired to the staff members on their units in three-hour-long sessions. The training involved staff role-playing scenarios based on teamwork problems that occur regularly on inpatient units in acute care hospitals followed by debriefing, which focused on teamwork behaviors (e.g., leadership, team orientation, backup, performance monitoring) and missed nursing care. Four measures were used to test the efficacy of this intervention: The Nursing Teamwork Survey, the MISSCARE Survey, and questions about the knowledge of and satisfaction with teamwork. Return rates for the surveys ranged from 73% to 84%. Follow-up tests individually comparing pretest, posttest, and delayed posttest were conducted within the mixed model and used the Bonferroni correction for multiple comparisons. Teamwork increased (F = 6.91, df = 259.01, p = .001) and missed care decreased (F = 3.59, df = 251.29, p = .03) over time. Nursing staff also reported a higher level of satisfaction with teamwork and an increase of teamwork knowledge after the intervention. The intervention tested in this study shows promise of being an effective and efficient approach to increase nursing teamwork and decrease missed nursing care.

  15. [Nursing diagnosis and interventions in a patient with multiple organ failure -- report of a case].

    PubMed

    Gerelli, A M; Soares, M A; Almeida, M A

    1999-07-01

    This study tries to identify Nursing Diagnoses and Interventions. It was done with a patient who was in critical health condition: multiple organs failure, in an Intensive Care Unit of a general hospital in Porto Alegre. The Case Study was the methodology used. Nursing Diagnoses is described mostly using NANDA Taxonomy. They are: Risk for Aspiration, Disuse Syndrome, Diarrhea, Risk for Infection, Impaired Tissue Integrity; and a Collaborative Problem was identified: Hypoglicemia. We have elaborated 34 Nursing Interventions for those diagnoses.

  16. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol

    PubMed Central

    Furberg, Robert D; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

    2016-01-01

    Background Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Objective Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. Methods The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care–related infections were reviewed to develop the infection control protocol to support tablet maintenance. Results This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. Conclusions These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings. PMID:27350013

  17. What do nurses do when they take to the streets? An analysis of psychiatric and mental health nursing interventions in the community.

    PubMed

    Wallace, Thérèse; O'Connell, Shelley; Frisch, Sara R

    2005-08-01

    Little research can be found on nursing practice for populations needing non-traditional mental health care. A descriptive study was done with the nurses on the Community Link Service (CLS), an intensive psychiatric community follow-up program, to identify nursing interventions and the types of situations encountered. These nurses use the guiding principles of two current treatment modalities, Assertive Community Treatment and Clinical Case Management. The Nursing Interventions Classification System (NIC, McCloskey & Bulecheck, 2000) was used to code nursing interventions reported through interviews and critical incidents. The nursing interventions represented 93 interventions and included 400 different activities. The analysis showed that Case Management (79%) and Complex Relationship Building (71%) were their most common interventions followed by Medication Management (64%) and Surveillance (60%). Systems such as the NIC are useful tools, but they may not give a complete description of nursing practice in this setting.

  18. Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain.

    PubMed

    Crowe, Linda; Chang, Anne; Fraser, Jennifer A; Gaskill, Deanne; Nash, Robyn; Wallace, Karen

    2008-12-01

    Objectives  The primary objective of this systematic review was to assess the effectiveness of nursing interventions for the relief/reduction of post-operative pain when compared with either standard care or other nursing interventions. Inclusion criteria  Types of studies This review included randomised controlled trials (RCTs) and other quasi-randomised experimental research designs. Types of participants Adults treated for post-operative pain in an acute care hospital. Types of interventions Interventions included in the review were only those directly administered by nursing staff such as: (i) administration of analgesia: including oral, intramuscular injection, patient controlled analgesia, epidural; (ii) pre-operative patient education; (iii) assessment and documentation of intensity of pain at regular intervals; (iv) protocols, clinical pathways or flow-sheets used in the management of pain; and (v) non-pharmacological interventions such as massage and relaxation. Types of outcome measures The primary outcome was the relief or reduction of post-operative pain. Other measures included analgesia consumption, patient satisfaction and length of hospital stay. Search strategy  Search terms were chosen after reviewing text words and MeSH terms in relevant articles and databases. A search for published and unpublished research covering the period 1985-2004 (inclusive) was conducted, using 11 major electronic databases. Reference lists of retrieved articles were hand searched. The search was restricted to reports published in English. Assessment of quality  The methodological quality of eligible studies was appraised by two independent reviewers, using a standardised critical appraisal tool. Differences in opinion were decided by consensus after discussion with a third investigator. Data extraction and analysis  Data were extracted from the studies that met the criteria for methodological quality. Two reviewers independently extracted data for each

  19. A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care

    PubMed Central

    Worthington, Catherine A.; O’Brien, Kelly K.; Mill, Judy; Caine, Vera; Solomon, Patty; Chaw-Kant, Jean

    2016-01-01

    We assessed the impact of an HIV care mentorship intervention on knowledge, attitudes, and practices with nurses and people living with HIV (PLWH) in Canada. We implemented the intervention in two urban and two rural sites with 16 mentors (eight experienced HIV nurses and eight PLWH) and 40 mentees (nurses with limited HIV experience). The 6- to 12-month intervention included face-to-face workshops and monthly meetings. Using a mixed-methods approach, participants completed pre- and postintervention questionnaires and engaged in semistructured interviews at intervention initiation, mid-point, and completion. Data from 28 mentees (70%) and 14 mentors (87%) were included in the quantitative analysis. We analyzed questionnaire data using McNemar test, and interview data using content analysis. Results indicated positive changes in knowledge, attitudes, and practices among nurse mentees, with qualitative interviews highlighting mechanisms by which change occurred. Mentorship interventions have the potential to engage and educate nurses in HIV treatment and care. PMID:27039195

  20. Reiki therapy: a nursing intervention for critical care.

    PubMed

    Toms, Robin

    2011-01-01

    Complementary and alternative medicine (CAM) is not generally associated with the complexity and intensity of critical care. Most CAM therapies involve slow, calming techniques that seem to be in direct contrast with the fast-paced, highly technical nature of critical care. However, patients in critical care often find themselves coping with the pain and stress of their illness exacerbated by the stress of the critical care environment. Complementary and alternative medicine-related research reveals that complementary therapies, such as Reiki, relieve pain and anxiety and reduce symptoms of stress such as elevated blood pressure and pulse rates. Patients and health care professionals alike have become increasingly interested in complementary and alternative therapies that do not rely on expensive, invasive technology, and are holistic in focus. Reiki is cost-effective, noninvasive, and can easily be incorporated into patient care. The purpose of this article is to examine the science of Reiki therapy and to explore Reiki as a valuable nursing intervention.

  1. Identity cues and dementia in nursing home intervention

    PubMed Central

    Vézina, Aline; Robichaud, Line; Voyer, Philippe; Pelletier, Daniel

    2013-01-01

    This study examines the identity cues that family caregivers and healthcare personnel use with seniors living with dementia and living in nursing homes. The identity cues represent biographical knowledge used to stimulate the dementia sufferer, trigger signals and incite interaction. Our grounded approach hinges on three objectives: to identify and categorize identity cues; to document their uses; and to gain a better understanding of their effectiveness. We interviewed nine family caregivers and 12 healthcare workers. Qualitative data indicates that the participants use identity cues that evoke seniors’ sociological, relational and individual characteristics. These identity cues play a central role in communication and constitute important information that the family caregivers can share with healthcare personnel. They sustain memory, facilitate care and reinforce seniors’ self-value. These results help to define identity, foster a greater role for family caregivers, and constitute a sound basis for the implementation of personalized interventions. PMID:21849743

  2. Nursing interventions for family members waiting during cardiac procedures.

    PubMed

    Trecartin, Kelly; Carroll, Diane L

    2011-08-01

    Anxiety is shared by patients and family members (FMs) and can increase throughout the FMs waiting during invasive cardiac procedures (ICP). The purpose of this study was to measure the effects of an informational report (IR) and a postprocedure visit (PPV), on the anxiety of waiting FMs. There were 151 FMs assigned to 3 groups; Group 1 (50 FMs: standard of care [SOC]), Group 2 (50 FMs: SOC + IR), and Group 3 (51 FMs: SOC + IR + PPV). Pre/ postvariables measured were: blood pressure (BP), heart rate (HR), skin temperature (ST), and anxiety. When comparing the BP, HR, ST, and anxiety there were no differences between groups with either SOC or IR. There was a significant reduction in anxiety, from baseline to the PPV in Group 3 (F = 10.1; p < .000). A PPV had an impact on FMs and a PPV should be incorporated as a nursing intervention during ICP.

  3. Factors influencing ambulance nurses' adherence to a national protocol ambulance care: an implementation study in the Netherlands.

    PubMed

    Ebben, Remco H A; Vloet, Lilian C M; van Grunsven, Pierre M; Breeman, Wim; Goosselink, Ben; Lichtveld, Rob A; Mintjes-De Groot, Joke A J; van Achterberg, Theo

    2015-06-01

    Adherence to prehospital guidelines and protocols is suboptimal. Insight into influencing factors is necessary to improve adherence. The aim of this study was to identify factors that influence ambulance nurses' adherence to a National Protocol Ambulance Care (NPAC). A questionnaire was developed using the literature, a questionnaire and expert opinion. Ambulance nurses (n=452) from four geographically spread emergency medical services (EMSs) in the Netherlands were invited to fill out the questionnaire. The questionnaire included questions on influencing factors and self-reported adherence. Questionnaires were returned by 248 (55%) of the ambulance nurses. These ambulance nurses' adherence to the NPAC was 83.4% (95% confidence interval 81.9-85.0). Bivariate correlations showed 23 influencing factors that could be related to the individual professional, organization, protocol characteristics and social context. Multilevel regression analysis showed that 21% of the variation in adherence (R=0.208) was explained by protocol characteristics and social influences. Ambulance nurses' self-reported adherence to the NPAC seems high. To improve adherence, protocol characteristics (complexity, the degree of support for diagnosis and treatment, the relationship of the protocol with patient outcomes) and social influences (expectance of colleagues to work with the national protocol) should be addressed.

  4. Nurse-Driven Catheter-Associated Urinary Tract Infection Reduction Process and Protocol: Development Through an Academic-Practice Partnership.

    PubMed

    Johnson, Pamela; Gilman, Anna; Lintner, Alicia; Buckner, Ellen

    2016-01-01

    Translating evidence-based practices to the bedside can be facilitated by an active academic-practice partnership between nursing faculty and frontline nursing staff. A collaborative effort between the university's academic nurses and the medical center's clinical nurses explored, created, implemented, and evaluated an evidence-based nurse-driven protocol for decreasing the rate of catheter-associated urinary tract infections. The nurse-driven protocol was piloted in 4 intensive care units and included nurse-driven orders for catheter discontinuation, utilization of smaller bore urinary catheters, addition of silver-based cleansing products for urinary catheter care, and education of staff on routine catheter care and maintenance. Data were collected for more than 8 months pre- and postimplementation of the nurse-driven protocol. Postimplementation data revealed a 28% reduction in catheter-associated urinary tract infections in the intensive care units as compared with preimplementation. Secondary benefits of this academic-practice partnership included strengthening the legitimacy of classroom content as lessons learned were integrated into courses in the nursing curriculum. The result of the partnership was a stronger sense of collaboration and collegiality between hospital staff and the university faculty. Transformative leadership engaged numerous stakeholders through collaborative efforts to realize best practices. An academic-practice partnership facilitates transformative change and provides structural stability and sustainability.

  5. Mental health first aid training for nursing students: a protocol for a pragmatic randomised controlled trial in a large university.

    PubMed

    Crawford, Gemma; Burns, Sharyn K; Chih, Hui Jun; Hunt, Kristen; Tilley, P J Matt; Hallett, Jonathan; Coleman, Kim; Smith, Sonya

    2015-02-19

    The impact of mental health problems and disorders in Australia is significant. Mental health problems often start early and disproportionately affect young people. Poor adolescent mental health can predict educational achievement at school and educational and occupational attainment in adulthood. Many young people attend higher education and have been found to experience a range of mental health issues. The university setting therefore presents a unique opportunity to trial interventions to reduce the burden of mental health problems. Mental Health First Aid (MHFA) aims to train participants to recognise symptoms of mental health problems and assist an individual who may be experiencing a mental health crisis. Training nursing students in MHFA may increase mental health literacy and decrease stigma in the student population. This paper presents a protocol for a trial to examine the efficacy of the MHFA training for students studying nursing at a large university in Perth, Western Australia. This randomised controlled trial will follow the CONSORT guidelines. Participants will be randomly allocated to the intervention group (receiving a MHFA training course comprising two face to face 6.5 hour sessions run over two days during the intervention period) or a waitlisted control group (not receiving MHFA training during the study). The source population will be undergraduate nursing students at a large university located in Perth, Western Australia. Efficacy of the MHFA training will be assessed by following the intention-to-treat principle and repeated measures analysis. Given the known burden of mental health disorders among student populations, it is important universities consider effective strategies to address mental health issues. Providing MHFA training to students offers the advantage of increasing mental health literacy, among the student population. Further, students trained in MHFA are likely to utilise these skills in the broader community, when they

  6. Comparative effectiveness of implementation of a nursing-driven protocol in reducing bronchodilator utilization for hospitalized children with bronchiolitis.

    PubMed

    Pinto, Jamie M; Schairer, Janet L; Petrova, Anna

    2014-06-01

    The goal of our study was to determine whether the administration of bronchodilators is affected by implementation of a nursing-driven protocol in the care of children hospitalized with bronchiolitis. We included children less than 2 years old, hospitalized with bronchiolitis, but without chronic lung problems, immunodeficiencies or congenital heart disease in the 1-year periods before, during and after implementation of a nursing-driven bronchiolitis protocol. The protocol is based on nursing assessments of respiratory status prior to initiation and continuation of bronchodilator therapy. Utilization rates of bronchodilators were compared with respect to implementation of the nursing-driven protocol using Chi-square, analysis of variance, and regression analysis that is presented as adjusted odds ratio (OR) and 95% confidence interval (95% CI) of the OR. Among the 80 children who were hospitalized before, 63 during and 89 after the implementation of the nursing-driven bronchiolitis protocol, 70.0, 60.3, and 29.2%, respectively, received treatment with bronchodilators (P < 0.0001). Reduction in the use of bronchodilators in association with the implementation of the nursing-driven bronchiolitis protocol was also observed after controlling for the child's age and evidence of pneumonia (OR 0.68, 95% CI 0.61-0.79). The mean number of bronchodilator doses administered among patients in the three groups who received at least one treatment was comparable. Implementation of a nursing-driven bronchiolitis protocol was associated with significant reduction in initiation of bronchodilator treatments, which suggests a benefit from nursing involvement in the promotion of evidence-based recommendations in the management of children hospitalized with bronchiolitis. © 2014 John Wiley & Sons, Ltd.

  7. Patients and ICU nurses' perspectives of non-pharmacological interventions for pain management.

    PubMed

    Gélinas, Céline; Arbour, Caroline; Michaud, Cécile; Robar, Lauren; Côté, José

    2013-11-01

    Pain is a major stressor for critically ill patients. To maximize pain relief, non-pharmacological interventions are an interesting avenue to explore. The study aim was to describe the perspectives of patients/family members and nurses about the usefulness, relevance and feasibility of non-pharmacological interventions for pain management in the intensive care unit (ICU). A qualitative descriptive design was used. Patients/family members (n = 6) with a previous experience of ICU hospitalization and ICU nurses (n = 32) were recruited. Using a semi-structured discussion guide, participants were asked to share their perspective about non-pharmacological interventions that they found useful, relevant and feasible for pain management in the ICU. Interventions were clustered into five categories: a) cognitive-behavioural, b) physical, c) emotional support, d) helping with activities of daily living and, e) creating a comfortable environment. A total of eight focus groups (FGs) with patients/family members (two FGs) and ICU nurses (six FGs) were conducted. Overall, 33 non-pharmacological interventions were discussed. The top four non-pharmacological interventions found to be useful, relevant and feasible in at least half of the FGs were music therapy and distraction (cognitive-behavioural category), simple massage (physical category) and family presence facilitation (emotional support category). Interestingly, patients/family members and nurses showed different interests towards some interventions. For instance, patients discussed more about active listening/reality orientation, while nurses talked mostly about teaching/positioning. Four non-pharmacological interventions reached consensus in patients and nurses' FGs to be useful, relevant and feasible for pain management in the ICU. Other interventions seemed to be influenced by personal experience or professional role of the participants. While more evidence is required to conclude to their effectiveness, ICU nurses can

  8. [Autonomic dysreflexia and nursing interventions for patients with spinal cord injury].

    PubMed

    de Andrade, Leonardo Tadeu; de Araújo, Eduardo Gomes; Andrade, Karla da Rocha Pimenta; de Souza, Danyelle Rodrigues Pelegrino; Garcia, Telma Ribeiro; Chianca, Tânia Couto Machado

    2013-02-01

    This retrospective study, performed in 2009, aimed to identify nursing diagnoses and interventions for the care of patients with spinal cord injury. Data were collected from the nursing records of 465 patients with SCI undergoing rehabilitation. The nursing diagnosis Risk for autonomic dysreflexia was identified in 271 clinical records (58, 3%). Approximately 80 patients developed autonomic dysreflexia, with a predominance in young men around 35.7 years old, who had experienced a trauma as the main cause of the injury. Their neurological injury level was at the sixth thoracic vertebra or above. Nursing interventions were arranged in two groups, one focused on prevention and the other on treatment. An intervention guide was developed and can be used by nurses in their clinical practice of rehabilitation and can be included into information systems. The removal of the stimulus which causes autonomic dysreflexia was identified as the most effective therapy and the best intervention.

  9. Comparing accuracy of the Yale swallow protocol when administered by registered nurses and speech-language pathologists.

    PubMed

    Warner, Heather L; Suiter, Debra M; Nystrom, Karin V; Poskus, Kelly; Leder, Steven B

    2014-07-01

    (1) To describe the results of a web-based teaching module used by registered nurses to identify patients at risk of aspiration and (2) to determine accuracy of the registered nurse-administered 3-ounce water swallow challenge protocol, that is, drinking three ounces of water, a basic cognitive screen and oral mechanism evaluation, when compared with blinded ratings from speech-language pathology. Early identification of potential swallowing problems is important prior to ingestion of food, fluid and medications. Unfortunately, current nurse-administered screens use a variety of non-evidence-based assessments. It would be beneficial to use a valid, reliable and evidence-based screen, that is, the Yale swallow protocol. Prospective, blinded, referral-based. Fifty-two registered nurses and 101 inpatients participated. First, each participant was administered the 3-ounce water swallow challenge protocol by a speech-language pathologist. Second, a nurse administered the protocol to the same patient within one hour and independently recorded results and diet recommendations. The nurse was blinded to the study's purpose and results of the speech-language pathologist's initial screening. Out of view, but simultaneous with the nurse-administered protocol, a speech-language pathologist rerated the patient's challenge for comparison with initial results and determined the accuracy of the nurse-administered protocol. Intra- and inter-rater protocol agreements for the two speech-language pathologists were 100%. Inter-rater protocol agreement between registered nurses and speech-language pathologists was 98·01%. Results confirm the reliability and accuracy of a registered nurse-administered Yale swallow protocol. The consequence of 98% accuracy combined with previously reported 96·5% sensitivity, 97·9% negative predictive value and <2% false negative rate allowed for adoption of the protocol for the entire general hospital population. Avoidance of preventable prandial

  10. Comparison of the Effectiveness of Two Protocols for Treating Nursing Home Residents with Advanced Dementia

    PubMed Central

    Kovach, Christine R.; Simpson, Michelle R.; Joosse, Laura; Logan, Brent R.; Noonan, Patricia E.; Reynolds, Sheila A.; Woods, Diana Lynn; Raff, Hershel

    2012-01-01

    The Serial Trial Intervention (STI) is a decision support tool to address the problem of under assessment and treatment of pain and other unmet needs of people with dementia. This study compared the effectiveness of the 5-step and 9-step versions of the STI using a two-group repeated measures quasi-experimental design with randomization of 12 matched nursing homes. The sample consisted of 125 residents with moderate to severe dementia. Both the 5 and 9-step STIs significantly decreased discomfort and agitation from pre to posttest (effect sizes .45 to .90). The 9-step version was more effective for comorbid burden and increased cortisol slope (effect sizes .5 and .49). Process variables were all statistically significantly improved using the 9-step STI. Nurse time was not different between the two groups. The clinical decision support rules embedded in the STI, particularly the 9-step version, helped nurses change practice and improved resident outcomes. PMID:22998656

  11. [Diagnosis "risk of pneumonia" evidence-based evaluation and comparison of nursing interventions].

    PubMed

    Haslinger-Baumann, Elisabeth; Burns, Evelin

    2007-12-01

    In home nursing care, professionally qualified nurses make decisions on their own which must be based on the latest scientific research. The goal of this systematic literature review was to examine if the interventions of the diagnosis "Risk of Pneumonia" as used by a home care service provider in Austria are based on scientific evidence. Based on the research question "Can the interventions of the diagnosis 'risk of pneumonia' be found in the scientific nursing literature?", four evidence-based guidelines from various databases and institutes were identified and evaluated using a standardized checklist. The result of the analysis is that the majority of the Nursing diagnosis interventions can be found in the guidelines. It is also recommended in the guidelines to advise and support clients to stop smoking and inoculate against influenza/pneumonia. Similarly, assessment tools should be used to estimate the severity of pneumonia. The intervention of oral hygiene as a prophylactic intervention against pneumonia should get particular attention.

  12. Nursing interventions and outcomes classifications in patients with wounds: cross-mapping.

    PubMed

    Oliveira, Fernanda Pessanha de; Oliveira, Beatriz Guitton Renaud Baptista de; Santana, Rosimere Ferreira; Silva, Bruna de Paula; Candido, Jessica de Souza Carvalho

    2016-06-01

    Objective Cross-mapping of terms referring to nursing interventions and outcomes in the medical records of patients with wounds compared to nursing interventions and nursing outcomes classifications. Method An observational retrospective study based on cross-mapping. The sample consisted of 81 outpatients treated in a university hospital in Rio de Janeiro. Data was collected from medical records between May and July of 2013. The analysis was done in four steps: search for phrases used to describe interventions and outcomes; setting the frequency of occurrence of phrases; grouping synonyms; comparison of terms with taxonomies. Results 13 interventions were mapped and the most frequent was "Care with wounds" (47.23%). Also, 6 results were mapped and the priority was "Wound healing: secondary intention" (45%). Conclusions The use of cross-mapping of terms referring to interventions and nursing outcomes in patients with wounds suggested additions to the taxonomies for adaptation to outpatient care.

  13. The pro children intervention: applying the intervention mapping protocol to develop a school-based fruit and vegetable promotion programme.

    PubMed

    Pérez-Rodrigo, Carmen; Wind, Marianne; Hildonen, Christina; Bjelland, Mona; Aranceta, Javier; Klepp, Knut-Inge; Brug, Johannes

    2005-01-01

    The importance of careful theory-based intervention planning is recognized for fruit and vegetable promotion. This paper describes the application of the Intervention Mapping (IM) protocol to develop the Pro Children intervention to promote consumption of fruit and vegetable among 10- to 13-year-old schoolchildren. Based on a needs assessment, promotion of intake of fruit and vegetable was split into performance objectives and related personal, social and environmental determinants. Crossing the performance objectives with related important and changeable determinants resulted in a matrix of learning and change objectives for which appropriate educational strategies were identified. Theoretically similar but culturally relevant interventions were designed, implemented and evaluated in Norway, the Netherlands and Spain during 2 school years. Programme activities included provision of fruits and vegetables in the schools, guided classroom activities, computer-tailored feedback and advice for children, and activities to be completed at home with the family. Additionally, optional intervention components for community reinforcement included incorporation of mass media, school health services or grocery stores. School project committees were supported. The Pro Children intervention was carefully developed based on the IM protocol that resulted in a comprehensive school-based fruit and vegetable promotion programme, but culturally sensible and locally relevant. (c) 2005 S. Karger AG, Basel

  14. Self-management support intervention to control cancer pain in the outpatient setting: a randomized controlled trial study protocol.

    PubMed

    Hochstenbach, Laura M J; Courtens, Annemie M; Zwakhalen, Sandra M G; van Kleef, Maarten; de Witte, Luc P

    2015-05-19

    Pain is a prevalent and distressing symptom in patients with cancer, having an enormous impact on functioning and quality of life. Fragmentation of care, inadequate pain communication, and reluctance towards pain medication contribute to difficulties in optimizing outcomes. Integration of patient self-management and professional care by means of healthcare technology provides new opportunities in the outpatient setting. This study protocol outlines a two-armed multicenter randomized controlled trial that compares a technology based multicomponent self-management support intervention with care as usual and includes an effect, economic and process evaluation. Patients will be recruited consecutively via the outpatient oncology clinics and inpatient oncology wards of one academic hospital and one regional hospital in the south of the Netherlands. Irrespective of the stage of disease, patients are eligible when they are diagnosed with cancer and have uncontrolled moderate to severe cancer (treatment) related pain defined as NRS≥4 for more than two weeks. Randomization (1:1) will assign patients to either the intervention or control group; patients in the intervention group receive self-management support and patients in the control group receive care as usual. The intervention will be delivered by registered nurses specialized in pain and palliative care. Important components include monitoring of pain, adverse effects and medication as well as graphical feedback, education, and nurse support. Effect measurements for both groups will be carried out with questionnaires at baseline (T0), after 4 weeks (T1) and after 12 weeks (T2). Pain intensity and quality of life are the primary outcomes. Secondary outcomes include self-efficacy, knowledge, anxiety, depression and pain medication use. The final questionnaire contains also questions for the economic evaluation that includes both cost-effectiveness and cost-utility analysis. Data for the process evaluation will be

  15. Nurses' expert opinions of workplace interventions for a healthy working environment: a Delphi survey.

    PubMed

    Doran, Diane; Clarke, Sean; Hayes, Laureen; Nincic, Vera

    2014-09-01

    Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.

  16. Development of a post-simulation debriefing intervention to prepare nurses and nursing students to care for deteriorating patients.

    PubMed

    Lavoie, Patrick; Pepin, Jacinthe; Cossette, Sylvie

    2015-05-01

    To provide optimal care, nurses need to be prepared to recognize signs and symptoms of patient deterioration so they can obtain assistance from appropriate respondents and initiate rescue interventions when needed. In this paper, we describe the development of a post-simulation educational intervention aimed at improving nurses' and nursing students' recognition and response to patient deterioration. This intervention takes the form of a debriefing after a simulated patient deterioration experience. Following the Medical Research Council's guidance on complex interventions, we reviewed empirical studies of existing educational interventions for content, teaching strategies, and outcomes, as well as for frameworks, theoretical underpinnings, and rationale. Based on those results, we reviewed theoretical literature (Tanner's clinical judgment model and Dewey's theory of experiential learning) that might inform our understanding of our intervention's intended effect (learning outcomes) and of the mechanisms by which the intervention could lead to it. Integrating results from the empirical and theoretical phases helped us define the new intervention's rationale and develop its components according to relevant standards of best practices. The resulting educational intervention, REsPoND, consists in a reflective debriefing after a patient deterioration simulation. It will be tested in an upcoming mixed methods study.

  17. Meaning in bone marrow transplant nurses' work: experiences before and after a "meaning-centered" intervention.

    PubMed

    Leung, Doris; Fillion, Lise; Duval, Stéphane; Brown, Jocelyn; Rodin, Gary; Howell, Doris

    2012-01-01

    When a clinical culture emphasizes cure, as in bone marrow transplantation (BMT) services, BMT nurses commonly experience enormous stress when patients are suffering or dying. In this context, it is unclear what meanings BMT nurses experience in their work and how they find meaning and sustain hope, given conflicting responsibilities to patients. This study aimed to explore BMT nurses' experiences of meaning and hope and the effects of a meaning-centered intervention (MCI) on these experiences using qualitative methodology. Fourteen BMT nurses engaged in a 5-session MCI, with 7 members each participating in 2 groups. Semistructured qualitative interviews were conducted at 1 month before and after the intervention. Interpretive phenomenology guided data analysis. The BMT nurses in the Princess Margaret Hospital experienced meaning in their involvement with their patients' suffering. The MCI seemed to inspire participants to engage more with patients and their suffering. Three subthemes reflected this influence: (a) greater awareness of boundaries between their personal and professional involvement, (b) enhanced empathy from an awareness of a shared mortality, and (c) elevated hope when nurses linked patients' suffering with meaning. This study confirms that patients' suffering constitutes nurses' search for meaning and hope in their work. The MCI offers a way in which to actively support nurses in this process. Nurses can learn to be more responsive to patients' suffering beyond limits of cure. A minimal intervention, such as the MCI, supports BMT nurses in finding positive personal meaning and purpose in their otherwise highly stressful work culture.

  18. An educational intervention to improve nurses' knowledge, attitude, and practice toward reporting of adverse drug reactions.

    PubMed

    Hanafi, Somayeh; Torkamandi, Hassan; Hayatshahi, Alireza; Gholami, Kheirollah; Shahmirzadi, Nikinaz Ashrafi; Javadi, Mohammad Reza

    2014-01-01

    The reporting of adverse drug reactions (ADRs) by nurses in hospitals is very important. This study was aimed at investigating the impact of an educational intervention to improve ADR reporting and whether trained nurses had better knowledge, attitude, and practice toward ADR reporting. A total of 300 nurses in a tertiary care teaching hospital in Tehran, Iran were evaluated with a knowledge, attitude, and practice (KAP) questionnaire regarding ADR reporting in March 2010. After this, an educational program about ADR was provided to nurses. Then the nurses were re-evaluated by the same questionnaire. Comparisons were made of the attitude and knowledge within nurses, before and after education. Data were analyzed using SPSS software. P < 0.05 was considered as significant level. Independent-sample t-test was used to measure the intervention effect. The response rate was 61.3% (N = 184). Knowledge of nurses before the intervention was significantly less than the knowledge after the intervention (P = 0.001). Also, there was a significant effect on attitude (P = 0.002). During the follow-up period of 4 months after the intervention, 26 spontaneous reports were received. Continuous ADR educational program, training, and integration of ADRs' reporting into the activities of the nurses would likely improve ADR reporting.

  19. An intervention to improve nurse-physician communication in depression care.

    PubMed

    Brown, Ellen L; Raue, Patrick J; Klimstra, Sibel; Mlodzianowski, Amy E; Greenberg, Rebecca L; Bruce, Martha L

    2010-06-01

    Depression in older adult home care recipients is frequently undetected and inadequately treated. Failed communication between home healthcare personnel and the patient's physician has been identified as a barrier for depression care. The purpose of this pilot intervention study was to improve nurse competency for communicating depression-related information to the physician. A single group pre-post experimental design. Two Medicare-certified home healthcare agencies serving an urban and suburban area in New York. Twenty-eight home care nurses, all female Registered Nurses. Two-hour skills training workshop. To evaluate the intervention, pre-post changes in effective nurse communication using Objective Structured Clinical Examinations and nurse survey reports. The intervention significantly improved the ability of the home care nurse to perform a case presentation in a complete and standard organized format pre versus postintervention. The intervention also increased nurse-reported certainty to communicate depression-related information to the physician. Our findings provide support for the ability of a brief, depression-focused communication skills training intervention to improve home care nurse competency for effectively communicating depression-related information to the physician.

  20. Psychological interventions helping pediatric oncology patients cope with medical procedures: a nurse-centered approach.

    PubMed

    Weinstein, Aurélie G; Henrich, Christopher C

    2013-12-01

    This study explored whether psychological interventions are currently used by pediatric oncology nurses to help children cope with their treatment and, if so, which interventions were considered by oncology nurses to be the most effective. A web-based survey was developed to assess pediatric oncology nurses' impressions of psychological care for pediatric patients during their medical treatment. A sample of 88 pediatric oncologic nurses from twelve leading pediatric oncology departments in the US participated in the survey. The closed questions were analyzed through quantitative methods with statistics. The open questions were examined through qualitative methods with report narratives and discourse analysis. Pediatric oncology nurses identified three psychological interventions to reduce suffering: educating children by explaining the procedure; providing emotional support to children by listening, answering children's worries, or holding their hands; and distracting children through passive and active forms. The survey further showed that nurses spent on average 3 h per day providing emotional support, would be willing to be trained in additional interventions (93%), and could devote at least 10 min per treatment to provide support (77%). This work demonstrates the central role nurses play as emotional support caregivers. Since nurses would be willing to provide emotional support during treatments, training may be an approach to incorporate the use of psychological interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Virtual Nursing Intervention Adjunctive to Conventional Care: The Experience of Persons Living With HIV.

    PubMed

    Côté, José; Rouleau, Geneviève; Ramirez-Garcia, Pilar; Bourbonnais, Anne

    2015-10-20

    Persons living with HIV (PLHIV) must adhere optimally to antiretroviral therapy (ART) on a daily basis and for their lifetime to maintain an undetectable viral load, allowing them to preserve their health. Taking advantage of the opportunity that information and communication technologies provide to broaden intervention modalities and intensify clinical follow-up, a virtual nursing intervention consisting of four interactive computer sessions was developed to empower PLHIV to manage their ART and symptoms optimally. Compared with other types of information and communication technologies-assisted interventions such as text messages, HIV Treatment, Virtual Nursing Assistance and Education (VIH-TAVIE) requires a certain degree of active engagement on the part of the user to develop and strengthen the self-management skills to optimize adherence. After the intervention's impact on ART adherence was measured quantitatively, a qualitative study was undertaken to describe how users experience the intervention. Understanding how PLHIV perceive being assisted asynchronously by a virtual nurse was of particular interest. The objective of the study was to explore and describe how PLHIV experience VIH-TAVIE, that is, receiving customized asynchronous accompaniment via a virtual nurse. A qualitative study was conducted with 26 PLHIV (20 men, 6 women) who received all four VIH-TAVIE sessions. Participants had been diagnosed with HIV 14 years earlier on average and had been on ART for a mean period of 10 years. The sessions lasted 20-30 minutes each and were received two weeks apart. They are hosted by a virtual nurse who engages the user in a self-management skills-learning process for the purpose of treatment adherence. Semistructured interviews were conducted lasting 30-40 minutes to get participants to share their experience of the intervention through personal stories and what they thought and felt during their participation. Data were analyzed using Miles and Huberman

  2. Nurse interventions to improve medication adherence among discharged older adults: a systematic review.

    PubMed

    Verloo, Henk; Chiolero, Arnaud; Kiszio, Blanche; Kampel, Thomas; Santschi, Valérie

    2017-09-01

    discharged older adult inpatients are often prescribed numerous medications. However, they only take about half of their medications and many stop treatments entirely. Nurse interventions could improve medication adherence among this population. to conduct a systematic review of trials that assessed the effects of nursing interventions to improve medication adherence among discharged, home-dwelling and older adults. we conducted a systematic review according to the methods in the Cochrane Collaboration Handbook and reported results according to the PRISMA statement. We searched for controlled clinical trials (CCTs) and randomised CCTs (RCTs), published up to 8 November 2016 (using electronic databases, grey literature and hand searching), that evaluated the effects of nurse interventions conducted alone or in collaboration with other health professionals to improve medication adherence among discharged older adults. Medication adherence was defined as the extent to which a patient takes medication as prescribed. out of 1,546 records identified, 82 full-text papers were evaluated and 14 studies were included-11 RCTs and 2 CCTs. Overall, 2,028 patients were included (995 in intervention groups; 1,033 in usual-care groups). Interventions were nurse-led in seven studies and nurse-collaborative in seven more. In nine studies, adherence was higher in the intervention group than in the usual-care group, with the difference reaching statistical significance in eight studies. There was no substantial difference in increased medication adherence whether interventions were nurse-led or nurse-collaborative. Four of the 14 studies were of relatively high quality. nurse-led and nurse-collaborative interventions moderately improved adherence among discharged older adults. There is a need for large, well-designed studies using highly reliable tools for measuring medication adherence.

  3. Improving access to care and clinical outcome for pediatric behavioral problems: a randomized trial of a nurse-administered intervention in primary care.

    PubMed

    Kolko, David J; Campo, John V; Kelleher, Kelly; Cheng, Yu

    2010-06-01

    To determine the effectiveness of an on-site modular intervention in improving access to mental health services and outcomes for children with behavioral problems in primary care relative to enhanced usual care. The study includes boys and girls from six primary care offices in metropolitan Pittsburgh, PA. One hundred sixty-three clinically referred children who met a modest clinical cutoff (75th percentile) on the externalizing behavior scale of the Pediatric Symptom Checklist-17 were randomized to a protocol for on-site, nurse-administered intervention or to enhanced usual care. Protocol for on-site, nurse-administered intervention applied treatment modules from an evidence-based specialty mental health treatment for children with disruptive behavior disorders that were adapted for delivery in the primary care setting; enhanced usual care offered diagnostic assessment, recommendations, and facilitated referral to a specialty mental health provider in the community. The main outcome measures such as standardized rating scales, including the Pediatric Symptom Checklist-17, individualized target behavior ratings, treatment termination reports, and diagnostic interviews were collected. Protocol for on-site, nurse-administered intervention cases were significantly more likely to receive and complete mental health services, reported fewer service barriers and more consumer satisfaction, and showed greater, albeit modest, improvements on just a few clinical outcomes that included remission for categorical behavioral disorders at 1-year follow-up. Both conditions also reported several significant improvements on several clinical outcomes over time. A psychosocial intervention for behavior problems that was delivered by nurses in the primary care setting is feasible, improves access to mental health services, and has some clinical efficacy. Options for enhancing clinical outcome include the use of multifaceted collaborative care interventions in the pediatric practice.

  4. A Program To Educate School Nurses about Mental Health Interventions.

    ERIC Educational Resources Information Center

    Hootman, Janis; Houck, Gail M.; King, Mary Catherine

    2002-01-01

    Describes an educational program, which helped school nurses identify potential mental health problems. All school nurses in one district received the education, and six nurses developed and implemented practice improvement projects with at-risk students. The sessions addressed pathways to violence, therapeutic communication, and depression and…

  5. Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care

    PubMed Central

    2014-01-01

    Background There is a need for cost-effective weight management interventions that primary care can deliver to reduce the morbidity caused by obesity. Automated web-based interventions might provide a solution, but evidence suggests that they may be ineffective without additional human support. The main aim of this study was to carry out a feasibility trial of a web-based weight management intervention in primary care, comparing different levels of nurse support, to determine the optimal combination of web-based and personal support to be tested in a full trial. Methods This was an individually randomised four arm parallel non-blinded trial, recruiting obese patients in primary care. Following online registration, patients were randomly allocated by the automated intervention to either usual care, the web-based intervention only, or the web-based intervention with either basic nurse support (3 sessions in 3 months) or regular nurse support (7 sessions in 6 months). The main outcome measure (intended as the primary outcome for the main trial) was weight loss in kg at 12 months. As this was a feasibility trial no statistical analyses were carried out, but we present means, confidence intervals and effect sizes for weight loss in each group, uptake and retention, and completion of intervention components and outcome measures. Results All randomised patients were included in the weight loss analyses (using Last Observation Carried Forward). At 12 months mean weight loss was: usual care group (n = 43) 2.44 kg; web-based only group (n = 45) 2.30 kg; basic nurse support group (n = 44) 4.31 kg; regular nurse support group (n = 47) 2.50 kg. Intervention effect sizes compared with usual care were: d = 0.01 web-based; d = 0.34 basic nurse support; d = 0.02 regular nurse support. Two practices deviated from protocol by providing considerable weight management support to their usual care patients. Conclusions This study demonstrated the

  6. Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care.

    PubMed

    Yardley, Lucy; Ware, Lisa J; Smith, Emily R; Williams, Sarah; Bradbury, Katherine J; Arden-Close, Emily J; Mullee, Mark A; Moore, Michael V; Peacock, Janet L; Lean, Mike E J; Margetts, Barrie M; Byrne, Chris D; Hobbs, Richard F D; Little, Paul

    2014-05-21

    There is a need for cost-effective weight management interventions that primary care can deliver to reduce the morbidity caused by obesity. Automated web-based interventions might provide a solution, but evidence suggests that they may be ineffective without additional human support. The main aim of this study was to carry out a feasibility trial of a web-based weight management intervention in primary care, comparing different levels of nurse support, to determine the optimal combination of web-based and personal support to be tested in a full trial. This was an individually randomised four arm parallel non-blinded trial, recruiting obese patients in primary care. Following online registration, patients were randomly allocated by the automated intervention to either usual care, the web-based intervention only, or the web-based intervention with either basic nurse support (3 sessions in 3 months) or regular nurse support (7 sessions in 6 months). The main outcome measure (intended as the primary outcome for the main trial) was weight loss in kg at 12 months. As this was a feasibility trial no statistical analyses were carried out, but we present means, confidence intervals and effect sizes for weight loss in each group, uptake and retention, and completion of intervention components and outcome measures. All randomised patients were included in the weight loss analyses (using Last Observation Carried Forward). At 12 months mean weight loss was: usual care group (n = 43) 2.44 kg; web-based only group (n = 45) 2.30 kg; basic nurse support group (n = 44) 4.31 kg; regular nurse support group (n = 47) 2.50 kg. Intervention effect sizes compared with usual care were: d = 0.01 web-based; d = 0.34 basic nurse support; d = 0.02 regular nurse support. Two practices deviated from protocol by providing considerable weight management support to their usual care patients. This study demonstrated the feasibility of delivering a web-based weight

  7. Implementing a collaborative protocol in a sepsis intervention program: lessons learned.

    PubMed

    Casserly, Brian; Baram, Michael; Walsh, Patricia; Sucov, Andrew; Ward, Nicholas S; Levy, Mitchell M

    2011-02-01

    The objective of this prospective cohort study was to see the effect of the implementation of a Sepsis Intervention Program on the standard processes of patient care using a collaborative approach between the Emergency Department (ED) and Medical Intensive Care Unit (MICU). This was performed in a large urban tertiary-care hospital, with no previous experience utilizing a specific intervention program as routine care for septic shock and which has services and resources commonly available in most hospitals. The study included 106 patients who presented to the ED with severe sepsis or septic shock. Eighty-seven of those patients met the inclusion criteria for complete data analysis. The ED and MICU staff underwent a 3-month training period followed by implementation of a protocol for sepsis intervention program over 6 months. In the first 6 months of the program's implementation, 106 patients were admitted to the ED with severe sepsis and septic shock. During this time, the ED attempted to initiate the sepsis intervention protocol in 76% of the 87 septic patients who met the inclusion criteria. This was assessed by documentation of a central venous catheter insertion for continuous SvO(2) monitoring in a patient with sepsis or septic shock. However, only 48% of the eligible patients completed the early goal-directed therapy (EGDT) protocol. Our data showed that the in-hospital mortality rate was 30.5% for the 87 septic shock patients with a mean APACHE II score of 29. This was very similar to a landmark study of EGDT (30.5% mortality with mean APACHE II of 21.5). Data collected on processes of care showed improvements in time to fluid administration, central venous access insertion, antibiotic administration, vasopressor administration, and time to MICU transfer from ED arrival in our patients enrolled in the protocol versus those who were not. Further review of our performance data showed that processes of care improved steadily the longer the protocol was in

  8. Sleep disturbance, chronic stress, and depression in hospice nurses: testing the feasibility of an intervention.

    PubMed

    Carter, Patricia A; Dyer, Kathleen A; Mikan, Sabrina Q

    2013-09-01

    To test the feasibility of a cognitive-behavioral therapy for an insomnia (CBT-I) intervention in chronically bereaved hospice nurses. Five-week descriptive correlational. Nonprofit hospice in central Texas. 9 agency nurses providing direct patient and family care. Direct care nurses were invited to participate. Two intervention group sessions occurred at the hospice agency and included identification of dysfunctional thoughts and beliefs about sleep, stimulus control, sleep hygiene, and relaxation techniques to promote sleep. Measurements were taken at baseline and three and five weeks postintervention. Sleep quality, depressive symptoms, and narrative reflections on the impact of sleep quality on self-care. Participants reported moderate-to-severe sleep disturbances and moderate depressive symptoms. The CBT-I intervention was well accepted by the participants, and on-site delivery increased participation. Additional longitudinal study is needed to investigate the effectiveness of CBT-I interventions to improve self-care among hospice nurses who are at high risk for compassion fatigue and, subsequently, leaving hospice care. Hospice nurses are exposed to chronic bereavement that can result in sleep disturbances, which can negatively affect every aspect of hospice nurses' lives. Cognitive-behavioral sleep interventions show promise in teaching hospice nurses how to care for themselves by getting quality sleep. Identifying the risks for sleep disturbances and depressive symptoms in hospice nurses will allow for effective, individualized interventions to help promote health and well-being. If hospice nurses achieve quality sleep, they may remain in the profession without suffering from chronic bereavement, which can result in compassion fatigue. A CBT-I intervention delivered at the agency and in a group format was feasible and acceptable by study participants.

  9. Intervention to improve intensive care nurses' knowledge of sedation assessment and management.

    PubMed

    Ramoo, Vimala; Abdullah, Khatijah L; Tan, Patrick Sk; Wong, Li P; Chua, Piaw Y

    2016-09-01

    Sedation management is an integral component of critical care practice. It requires the greatest attention of critical care practitioners because it carries significant risks to patients. Therefore, it is imperative that nurses are aware of potential adverse consequences of sedation therapy and current sedation practice recommendations. To evaluate the impact of an educational intervention on nurses' knowledge of sedation assessment and management. A quasi-experimental design with a pre- and post-test method was used. The educational intervention included theoretical sessions on assessing and managing sedation and hands-on sedation assessment practice using the Richmond Agitation Sedation Scale. Its effect was measured using self-administered questionnaire, completed at the baseline level and 3 months following the intervention. Participants were 68 registered nurses from an intensive care unit of a teaching hospital in Malaysia. Significant increases in overall mean knowledge scores were observed from pre- to post-intervention phases (mean of 79·00 versus 102·00, p < 0·001). Nurses with fewer than 5 years of work experience, less than 26 years old, and with a only basic nursing education had significantly greater level of knowledge improvement at the post-intervention phase compared to other colleagues, with mean differences of 24·64 (p = 0·001), 23·81 (p = 0·027) and 27·25 (p = 0·0001), respectively. A repeated-measures analysis of variance revealed a statistically significant effect of educational intervention on knowledge score after controlling for age, years of work and level of nursing education (p = 0·0001, ηp (2) = 0·431). An educational intervention consisting of theoretical sessions and hands-on sedation assessment practice was found effective in improving nurses' knowledge and understanding of sedation management. This study highlighted the importance of continuing education to increase nurses' understanding of intensive care practices

  10. Education and Health Matters: School Nurse Interventions, Student Outcomes, and School Variables

    ERIC Educational Resources Information Center

    Wolfe, Linda C.

    2013-01-01

    This paper presents findings from a quantitative, correlational study that examined selected school nursing services, student academic outcomes, and school demographics. Ex post facto data from the 2011-2012 school year of Delaware public schools were used in the research. The selected variables were school nurse interventions provided to students…

  11. BE-ACTIV: A Staff-Assisted Behavioral Intervention for Depression in Nursing Homes

    ERIC Educational Resources Information Center

    Meeks, Suzanne; Looney, Stephen W.; Van Haitsma, Kimberly; Teri, Linda

    2008-01-01

    Purpose: This article (a) describes a 10-week, behavioral, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. Design and Methods: We developed BE-ACTIV, which stands for…

  12. Teaching a Course in Abnormal Psychology and Behavior Intervention Skills for Nursing Home Aides.

    ERIC Educational Resources Information Center

    Glenwick, David S.; Slutzsky, Mitchel R.; Garfinkel, Eric

    2001-01-01

    Describes an 11-week course given at a nursing home to nursing home aides that focused on abnormal psychology and behavior intervention skills. Discusses the course goals, class composition, and course description. Addresses the problems and issues encountered with teaching this course to a nontraditional population in an unconventional setting.…

  13. Teaching a Course in Abnormal Psychology and Behavior Intervention Skills for Nursing Home Aides.

    ERIC Educational Resources Information Center

    Glenwick, David S.; Slutzsky, Mitchel R.; Garfinkel, Eric

    2001-01-01

    Describes an 11-week course given at a nursing home to nursing home aides that focused on abnormal psychology and behavior intervention skills. Discusses the course goals, class composition, and course description. Addresses the problems and issues encountered with teaching this course to a nontraditional population in an unconventional setting.…

  14. A systematic method to document population-level nursing interventions in an electronic health system.

    PubMed

    Baisch, Mary Jo

    2012-01-01

    Many public health electronic health systems lack the specificity to distinguish between individual- and population-based levels of care provided by public health nurses. Data that describe the broad scope of the everyday practice of public health nurses are critical to providing evidence of their effectiveness in promoting community health, which may not be fully appreciated in an arena of scarce resources. This article describes a method to document population-based nursing practice by adding population-based interventions to the nursing taxonomy underlying an electronic health information system. These interventions, derived from the Intervention Wheel, were incorporated into the Omaha System taxonomy, the conceptual framework for the Automated Community Health Information System (ACHIS), which is a longstanding data system used to capture nursing practice in community nursing centers. This article includes a description of the development and testing of the system's ability to capture the practice of the district public health nurse model. This method of adapting an existing data system to capture population-based interventions could be replicated by public health administrators interested in better evaluating the processes and outcomes of public health nursing and other public health professionals.

  15. A Peer-Delivered Educational Intervention to Improve Nursing Student Cyberprofessionalism.

    PubMed

    Marnocha, Suzanne; Marnocha, Mark; Cleveland, Rebecca; Lambie, Christina; Limberg, Cassandra Y; Wnuk, Jacqueline

    2017-03-01

    Previous research documents online unprofessionalism among nursing students. The current study assessed the effects of a peer-facilitated social media education session on changes in attitudes and knowledge among recently admitted prelicensure nursing students. Uncertain or incorrect attitudes and knowledge showed significant improvements after the session. Such interventions may enhance cyberprofessionalism in future student cohorts and warrant further exploration.

  16. Nursing Intervention using smartphone technologies; a systematic review and meta-analysis.

    PubMed

    Jeon, Eunjoo; Park, Hyeoun-Ae

    2015-01-01

    We reviewed mobile technology-based interventions in nursing and computed effect size of the interventions. We searched eight databases (KoreaMED, KMBASE, KISS, NDSL, Medline, EMBASE, Cochrane central library and CINAHL) using three sets of terms: mobile application, mobile app, mobile phone or smartphone; health or healthcare; and nursing. The study design, mobile technology, sample size and clinical outcomes were extracted from each study. A total of 38 studies were selected for review. Seven and six studies were used in meta-analyses for weight and fasting plasma glucose changes respectively. We found that mobile interventions used in nursing have different characteristics compared to those in other disciplines. We also found that mobile interventions in nursing led to significant improvement in weight and glucose control.

  17. Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest – intervention – posttest study

    PubMed Central

    Dauer, Lawrence T; Kelvin, Joanne F; Horan, Christopher L; St Germain, Jean

    2006-01-01

    Background Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. Methods A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. Results As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. Conclusion The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses. PMID:16762060

  18. Conceptualization of an electronic system for documentation of nursing diagnosis, outcomes, and intervention.

    PubMed

    Peres, Heloisa Helena Ciqueto; de Almeida Lopes Monteiro da Cruz, Diná; Lima, Antônio Fernandes Costa; Gaidzinski, Raquel Rapone; Ortiz, Diley Cardoso Franco; Mendes e Trindade, Michelle; Tsukamoto, Rosangela; Batista de Oliveira, Neurilene

    2010-01-01

    Electronic nursing documentation constitutes technical, scientific, legal, and ethical documents. The objective of this study was to develop an electronic nursing documentation system. The system was developed in four phases (conceptualization, detailing, prototype building, implementation), and the knowledge base was based on domains and classes according to the NANDA-I, NIC, and NOC unified framework. The result is an electronic system (PROCEnf--USP--Nursing Process Electronic Documentation System of the University of São Paulo) which allows documenting nursing process generating reports of nursing process, besides supporting decisions on nursing diagnosis, expected outcomes, and interventions. Integration of different fields of knowledge, as well as the institutional feature of valuing continuous theoretical and practical improvement of nursing process were factors of success of this technological project.

  19. [The effect of an intervention on rates of nursing home residents transfers to emergency departments].

    PubMed

    Aizen, Efraim; Hindawi, Eman; Shahla, Hatim; Elyounes, Ahmad Abu

    2014-02-01

    Transfers of nursing home residents to emergency departments can result in iatrogenic complications, morbidity, and excess health care expenditure. Some of these transfers are potentially avoidable. To determine the rate of emergency department transfers of nursing home residents, prior to and following an intervention program that includes a set of tools and strategies designed to reduce these transfers. The present study was conducted in four departments at the Shfaram Geriatric Center (Beet Alenaya). The rate of emergency department transfers was determined in 118 residents of the nursing home during the 12 months prior to and during the 12 months following implementation and initiation of the intervention. Following the intervention, a significant reduction in the rate of emergency department transfers was observed in the study population from 2.61 to 1.28 transfers per 1,000 stay days, with a 50.1% transfer reduction (P < 0.005). The most significant reduction was observed among residents staying in the Complex Nursing Care Department (54.7%)(P < 0.05). The reduction rate among long term nursing care residents was modest (20.3%) and did not reach statistical significance. The implementation of such an intervention can reduce the rate of transfers of nursing home residents to emergency departments. Such interventions might lead to quality improvement in nursing homes and should be further evaluated in larger randomized controlled trials.

  20. An educational intervention to increase "speaking-up" behaviors in nurses and improve patient safety.

    PubMed

    Sayre, Michelle M; McNeese-Smith, Donna; Leach, Linda Searle; Phillips, Linda R

    2012-01-01

    "Speaking up" is a critical component in improving patient safety. Studies indicate, though, that most registered nurses prefer using behaviors of avoidance or accommodation in conflict situations. The purpose of this quasi-experimental study was to determine whether an educational intervention using scenarios, personal reflection, and peer support in small groups could improve speaking-up behaviors in registered nurses. Results showed a significant difference in speaking-up behaviors and scores in the intervention group (P < .001).

  1. The Dutch 'Focus on Strength' intervention study protocol: programme design and production, implementation and evaluation plan.

    PubMed

    Ten Hoor, G A; Kok, G; Rutten, G M; Ruiter, R A C; Kremers, S P J; Schols, A M J W; Plasqui, G

    2016-06-10

    Overweight youngsters are better in absolute strength exercises than their normal-weight counterparts; a physiological phenomenon with promising psychological impact. In this paper we describe the study protocol of the Dutch, school-based program 'Focus on Strength' that aims to improve body composition of 11-13 year old students, and with that to ultimately improve their quality of life. The development of this intervention is based on the Intervention Mapping (IM) protocol, which starts from a needs assessment, uses theory and empirical research to develop a detailed intervention plan, and anticipates program implementation and evaluation. This novel intervention targets first year students in preparatory secondary vocational education (11-13 years of age). Teachers are the program implementers. One part of the intervention involves a 30 % increase of strength exercises in the physical education lessons. The other part is based on Motivational Interviewing, promoting autonomous motivation of students to become more physically active outside school. Performance and change objectives are described for both teachers and students. The effectiveness of the intervention will be tested in a Randomized Controlled Trial in 9 Dutch high schools. Intervention Mapping is a useful framework for program planning a school-based program to improve body composition and motivation to exercise in 11-13 year old adolescents by a "Focus on Strength". NTR5676 , registered 8 February 2016 (retrospectively registered).

  2. A multidisciplinary intervention to facilitate return to work in cancer patients: intervention protocol and design of a feasibility study

    PubMed Central

    de Boer, Angela G E M; Frings-Dresen, Monique H W

    2012-01-01

    Introduction Returning to work can be problematic for cancer survivors due to suboptimal workplace support, a heavy workload, decreased physical functioning and fatigue. The timely and permanent return to work (RtW) of cancer patients favourably influences quality of life and economic independence. Multidisciplinary interventions aimed at timely and enduring RtW are lacking. The objectives of this article are (1) to describe the protocol of an intervention aimed at RtW of cancer patients, comprising of counselling by an oncological occupational physician and supervised physical exercise in a clinical setting during treatment and (2) to present the design of the study aimed at evaluating the feasibility of this intervention. Methods and analysis The intervention comprises three counselling sessions with an oncological occupational physician and a 12-week moderate-to-high intensity physical exercise programme, starting at the onset of chemotherapy. The intervention is aimed at cancer patients treated with curative intent, aged 18–60 years, employed and on sick leave. It will take place in two large medical centres in the Netherlands. The feasibility of the intervention will be evaluated as follows: the number of sessions, topics discussed and exercises executed will be registered by care providers; patients' and care providers' opinions will be assessed by questionnaires and interviews, respectively; and the proportion of invited patients that participated will be calculated. Ethics and dissemination The study results will be used for optimising the intervention content and may serve as a foundation for future implementation. The Medical Ethics Committees of the Academic Medical Center and the participating medical centres approved the study protocol. PMID:22786950

  3. Review of a fluid resuscitation protocol: "fluid creep" is not due to nursing error.

    PubMed

    Faraklas, Iris; Cochran, Amalia; Saffle, Jeffrey

    2012-01-01

    Recent reviews of burn resuscitation have included the suggestion that "fluid creep" may be influenced by practitioner error. Our center uses a nursing-driven resuscitation protocol that permits titration of fluid based on hourly urine output, including the addition of colloid when patients fail to respond appropriately. The purpose of this study was to examine protocol compliance. We reviewed 140 patients (26 children) with burns of ≥20% TBSA who received protocol-directed resuscitation from 2005 to 2010. We compared each patient's actual hourly fluid infusion with that predicted by the protocol. Sixty-seven patients (48%) completed resuscitation using crystalloid alone, whereas 73 patients required colloid supplementation. Groups did not differ in age, gender, weight, or time from injury to admission. Patients requiring colloid had larger median total burns (33.0 vs 23.5% TBSA) and full-thickness burns (15.5 vs 4.5% TBSA) and more inhalation injuries (60.3 vs 28.4%; P < .001) than those who resuscitated with crystalloid alone. Because we included basic maintenance fluids in their regimen, patients had median predicted requirements of 5.4 ml/kg/%TBSA. Crystalloid-only patients required fluid volumes close to Parkland predictions (4.7 ml/kg/%TBSA), whereas patients who received colloid required more fluid than the predicted volume (7.5 ml/kg/%TBSA). However, the hourly difference between the predicted and received fluids was a median of only 1.0% (interquartile range: -6.1 to 11.1%) and did not differ between groups. Pediatric patients had greater calculated differences than adults. Crystalloid patients exhibited higher urine outputs than colloid patients until colloid was started, suggesting that early over-resuscitation did not contribute to fluid creep. Adherence to our protocol for burn shock resuscitation was excellent overall. Fluid creep exhibited by more seriously injured patients was not due to nurses' failure to follow the protocol. This review has

  4. Cross Mapping Between the Priority Nursing Care for Stroke Patients Treated With Thrombolytic Therapy and the Nursing Interventions Classification (NIC).

    PubMed

    Nonnenmacher, Carine Lais; Ávila, Christiane Wahast; Mantovani, Vanessa Monteiro; de Oliveira Vargas, Mara Ambrosina; Echer, Isabel Cristina; de Fátima Lucena, Amália

    2016-06-09

    To verify the correspondence between the priority nursing care for stroke patients treated with thrombolytic therapy and the Nursing Interventions Classification (NIC). A cross-mapping study with a semi-structured interview was conducted with 11 expert nurses who described priority nursing care in clinical practice, and mapped it to the NIC. Eleven nursing care priorities cited by the nurses were mapped to eight NICs, including Thrombolytic Therapy Management (4270). There was correspondence between all priority nursing care interventions for stroke patients treated with thrombolytic therapy and the NIC. The nursing care cited by the nurses was corroborated by the NIC, providing evidence for the clinical practice. Verificar a correspondência entre os cuidados de enfermagem prioritários a pacientes com acidente vascular encefálico tratados com terapia trombolítica e a Classificação das Intervenções de Enfermagem (NIC). MÉTODOS: Estudo de mapeamento cruzado com uma entrevista semi-estruturada aplicada a 11 enfermeiros especialistas que descreveram os cuidados de enfermagem prioritários na prática clínica, e mapeados para a NIC. Onze cuidados de enfermagem prioritários foram citados pelos enfermeiros e mapeados em oito intervenções de enfermagem NIC, incluindo a Thrombolytic Therapy Management (4270). CONCLUSÕES: Houve correspondência entre todos os cuidados de enfermagem prioritários para pacientes com acidente vascular encefálico tratados com a terapia trombolítica e as intervençães de enfermagem NIC. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os cuidados de enfermagem citados pelos enfermeiros foram corroborados pela NIC, produzindo evidências para a prática clínica. © 2016 NANDA International, Inc.

  5. An occupation-based video feedback intervention for improving self-awareness: protocol and rationale.

    PubMed

    Schmidt, Julia; Fleming, Jennifer; Ownsworth, Tamara; Lannin, Natasha A

    2015-02-01

    Impaired self-awareness can limit rehabilitation outcomes for people with traumatic brain injury (TBI). Video feedback on occupational performance has been found to improve self-awareness after TBI when delivered according to specific principles. The purpose of this article is to describe an occupation-based video feedback intervention found to be effective in a randomized controlled trial to assist with translation into clinical practice. The intervention uses therapist-mediated video feedback on clients' occupational performance, aiming to facilitate self-reflection on performance and improve self-awareness. This paper describes the theoretical background, intervention principles, and protocol of the intervention. Therapists can use video feedback intervention, incorporating the principles in this article, to improve people's intellectual awareness and ability to recognize and correct errors during task performance after TBI without a negative impact on emotional status.

  6. Violence against psychiatric nurses: sensitive research as science and intervention.

    PubMed

    Lanza, Marilyn Lewis; Zeiss, Robert; Rierdan, Jill

    2006-01-01

    Psychiatric nurses are frequent victims of workplace violence, much of which is perpetrated by patients. In a review of literature on prevalence, perpetrators, and impact of violence on psychiatric nurses, we note that workplace violence is a virtually normative experience for the nurse, rather than a rare occurrence. Verbal violence and sexual harassment, like physical violence, are common experiences; in contrast to physical violence, these are often initiated by co-workers. The emotional impact of violence on psychiatric nurses is studied less often than frequency of exposure; we discuss hypotheses for this paucity of relevant research. Finally, we reflect on the implications of current research, concluding with recommendations for future research on violence against psychiatric nurses. In particular, we elaborate on the role of violence research in the healthcare setting as "sensitive research"--a research process that in itself may have both direct and indirect beneficial effects for the nursing profession.

  7. Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

    PubMed

    Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

    2016-08-01

    Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors.

  8. When they drink too much. Nursing interventions for patients with disordered water balance.

    PubMed

    Snider, K; Boyd, M A

    1991-07-01

    Disordered water balance affects as many as 60% of severely psychiatrically disabled persons. Most patients do not progress to the point of a medical emergency, but are in a state of mild chronic intoxication, making them unavailable for treatment and requiring nursing care to treat the effects of the chronic intoxicated state. Interventions depend on the severity of the disordered water balance and vary from teaching fluid intake control to controlling all patient access to fluids. Nursing management of water intoxication is a trial and error approach. Through a thorough assessment and close observation of the patient, the nurse can determine which interventions would be most appropriate for the patient.

  9. Validation of a free fall acrobatics intervention protocol to reduce neck loads during parachute opening shock.

    PubMed

    Westman, Anton; Äng, Björn O

    2015-01-01

    Elevated neck pain prevalence among skydivers is associated with exposure to repeated parachute opening shock (POS). A study is planned to evaluate a preventive free fall acrobatics intervention, but prior assessment of the protocol is necessary given the complex and safety-critical study environment. To validate an intervention protocol to reduce POS neck loads. A protocol was developed based on observational data and theoretical calculations. Six experts rated each component of the protocol on a four-point Likert scale, regarding relevance, simplicity/feasibility and safety, and responded to open-ended questions. Two iterations were made, each followed by consensus panel protocol revisions. The content validity index (CVI) was used to quantify ratings. A measure of universal agreement (CVI/UA) was computed as the proportion of components that achieved a rating ≥3 by all raters. For safety, a high-sensitivity CVI/UA was computed with a rating of no <4 (highest score) as acceptable. CVI/UA for relevance increased from 0.80 in the first assessment to 1.00 in the second; for simplicity from 0.50 to 0.63; and for safety from 0.70 to 1.00. High-sensitivity CVI/UA for safety increased from 0.10 to 0.75. Responses to open-ended questions included safety concerns for free fall stability, altitude awareness and concerns over comprehensibility. The proposed protocol has been improved in assessed relevance, simplicity and safety, and is considered validated for the start of the empirical trial. To what degree complex interventions should be preceded by open prevalidation is discussed.

  10. Validation of a free fall acrobatics intervention protocol to reduce neck loads during parachute opening shock

    PubMed Central

    Westman, Anton; Äng, Björn O

    2015-01-01

    Background Elevated neck pain prevalence among skydivers is associated with exposure to repeated parachute opening shock (POS). A study is planned to evaluate a preventive free fall acrobatics intervention, but prior assessment of the protocol is necessary given the complex and safety-critical study environment. Aim To validate an intervention protocol to reduce POS neck loads. Methods A protocol was developed based on observational data and theoretical calculations. Six experts rated each component of the protocol on a four-point Likert scale, regarding relevance, simplicity/feasibility and safety, and responded to open-ended questions. Two iterations were made, each followed by consensus panel protocol revisions. The content validity index (CVI) was used to quantify ratings. A measure of universal agreement (CVI/UA) was computed as the proportion of components that achieved a rating ≥3 by all raters. For safety, a high-sensitivity CVI/UA was computed with a rating of no <4 (highest score) as acceptable. Results CVI/UA for relevance increased from 0.80 in the first assessment to 1.00 in the second; for simplicity from 0.50 to 0.63; and for safety from 0.70 to 1.00. High-sensitivity CVI/UA for safety increased from 0.10 to 0.75. Responses to open-ended questions included safety concerns for free fall stability, altitude awareness and concerns over comprehensibility. Conclusions The proposed protocol has been improved in assessed relevance, simplicity and safety, and is considered validated for the start of the empirical trial. To what degree complex interventions should be preceded by open prevalidation is discussed. PMID:27900113

  11. Universal Postoperative Hip Instruction Protocol for Rehabilitation in Rural Skilled Nursing Facilities.

    PubMed

    Smith, Mary Atkinson; Smith, William Todd; Stanton, Marietta

    2015-01-01

    Hip fractures among the elderly increase the incidence of mortality and other health-related complications, lead to poor quality of life, and create major economic challenges. Elderly individuals often reside in rural skilled nursing facilities (SNFs) for rehabilitation after undergoing surgical fixation for a hip fracture. Orthopedic providers (OPs) can develop protocols that will encourage continuity of postoperative orthopedic follow-up care, guiding and educating SNF staff in best practices, and encouraging regular communication between SNF staff and OPs. The purpose of this article is to describe how an orthopedic practice developed a universal postoperative hip instruction protocol (UP-HIP) to promote a streamlined approach to postoperative follow-up assessment and rehabilitation for the elderly residing in rural SNFs. The overall goal of the UP-HIP is to provide the OP with assessment findings remotely and avoid putting frail elderly patients at risk by physically transporting them to and from follow-up appointments with the OP. Orthopedic clinic setting and rural SNFs. Comprehensive postoperative protocols focused on elderly patients with hip fracture in rural SNFs serve to improve remote communication during the rehabilitation phase and guide SNF in a coordinated approach to postoperative follow-up care. Future recommendations include the addition of telehealth technology to allow for remote real-time visual assessments by the OP while the elderly patient with hip fracture remains in the SNF environment. The UP-HIP allows the OP and case manager to ensure continuity of postoperative care by conducting remote follow-up postoperative visits with elderly patients with hip fracture while they remain in the rural SNF setting. Comprehensive evidence-based protocols assist OPs and case managers with remotely monitoring rehabilitation progress in the rural SNF setting more efficiently and consistently. Telehealth technology added to evidence-based protocols

  12. Educational intervention of undergraduate nursing students' confidence skills with alcohol and drug misusers.

    PubMed

    Rassool, G Hussein; Rawaf, Salman

    2008-04-01

    There is a paucity literature on the educational interventions and evaluation programmes in alcohol and drug with undergraduate nursing students in the United Kingdom and this study intends to add a body of knowledge to this area. The aim of the study was to assess the intervention confidence skills of undergraduate nursing students before and after an educational intervention on alcohol and drug misuse. The research study is a quasi-experimental, pre- and post-test design. The sample was made of four cohorts of undergraduate nursing students (n=110) enrolled at a course leading to a diploma or BSc in nursing from three educational institutions. A visual analogue scale was used to measure intervention confidence skills before and after the educational programme in alcohol and drug. The findings showed an improvement in the level of intervention confidence skills of undergraduate nursing students. Further research is needed to examine effectiveness of educational interventions in working with substance misusers and whether substance misuse education is the key predictor of changing in changing intervention confidence skills.

  13. "It's not just about walking.....it's the practice nurse that makes it work": a qualitative exploration of the views of practice nurses delivering complex physical activity interventions in primary care.

    PubMed

    Beighton, Carole; Victor, Christina; Normansell, Rebecca; Cook, Derek; Kerry, Sally; Iliffe, Steve; Ussher, Michael; Whincup, Peter; Fox-Rushby, Julia; Woodcock, Alison; Harris, Tess

    2015-12-12

    Physical activity (PA) is important for physical and mental health in adults and older adults. Interventions incorporating theory-based behaviour change techniques (BCTs) can be useful in helping people to increase their PA levels and can be delivered by practice nurses in primary care. We undertook two primary care based complex walking interventions among adults and older adults. Both interventions were underpinned by BCTs and delivered by practice nurses and we sought their views and experiences of delivering over 1400 complex PA consultations. Semi structured interviews with two practice nurse groups (n = 4 and n = 5) and two individual interviews (total n = 11) were conducted by independent facilitators; audio-recorded, transcribed verbatim and analysed using thematic analysis. Five key themes emerged as enablers and/or barriers to delivering the intervention: preparation and training; initial and ongoing support; adherence to the protocol; the use of materials and equipment; and engagement of participants. The themes were organised into a framework of 'pre-trial' and 'delivery of the intervention'. Two additional 'post-trial' themes were identified; changed practice and the future feasibility of the intervention. Nurses believed that taking part in the trial, especially the BCT training, enhanced the quality and delivery of advice and support they provided within routine consultations, although the lack of time available routinely makes this challenging. Delivering an effective behaviour change intervention in primary care requires adequate training and support for practice nurses both initially and throughout the trial as well as adequate consultation time. Enhanced skills from participating in such trials can lead to long-term changes, including more patient-centred consulting. PACE-Lift ISRCTN 42122561 , PACE-UP ISRCTN 98538934 .

  14. Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS)

    PubMed Central

    Maas, Edwin; Gildersleeve-Neumann, Christina; Jakielski, Kathy J.; Stoeckel, Ruth

    2014-01-01

    This paper reviews current trends in treatment for childhood apraxia of speech (CAS), with a particular emphasis on motor-based intervention protocols. The paper first briefly discusses how CAS fits into the typology of speech sound disorders, followed by a discussion of the potential relevance of principles derived from the motor learning literature for CAS treatment. Next, different motor-based treatment protocols are reviewed, along with their evidence base. The paper concludes with a summary and discussion of future research needs. PMID:25313348

  15. Perinatal death: bereavement interventions used by US and Spanish nurses and midwives.

    PubMed

    Steen, Sue E

    2015-02-01

    Little research has been published from a global perspective regarding needs of nurses and midwives related to perinatal bereavement. To identify needs and concerns of US and Spanish nurses and midwives who have worked with perinatal death and to identify the bereavement interventions they use to help families with this experience. A cross-sectional study was conducted. Data were collected in 2011 from US (n=44) and Spanish (n=15) nurses and midwives via a questionnaire. Statistically significant differences between the nurses/midwives in each country were found regarding needs relating to knowledge, communication skills and managing personal feelings. Interventions of accompanying, listening, offering keepsakes, baptism discussion, and funeral planning were also found to be significantly different between the two groups. These findings demonstrate a continued need to increase the standard and consistency of perinatal bereavement care worldwide. Bereavement education in nursing curricula and practice settings in both cultures is essential to increase the standard of care.

  16. Reducing anxiety: the employment of Therapeutic Touch as a nursing intervention.

    PubMed

    Cox, C L; Hayes, J A

    1997-12-01

    Patient anxiety is frequently associated with admission and treatment in Critical Care Units. In Critical Care, one aim is the promotion of comfort so that anxiety experienced by patients can be reduced. In this article, a quasi-experimental design which attempted to determine the effectiveness of Therapeutic Touch as a nursing intervention is described. It was hypothesized that Therapeutic Touch would promote comfort and reduce anxiety. Before implementation of the project, a semi-structured interview was conducted amongst nurses (n = 18) from an Intensive Care Unit in a District General Hospital in East London. Interviews were conducted in order to determine the nurses' perceptions of the effectiveness of Therapeutic Touch as a complementary therapy. Initial findings of nurse interviews, a nurse's personal experiences of administering Therapeutic Touch and a case study indicate there may be a place for Therapeutic Touch as an intervention for promoting comfort and reducing anxiety in Critical Care.

  17. Evaluation of an intervention on socio cultural communication skills of international nurses.

    PubMed

    Xu, Yu; Shen, Jay; Bolstad, Anne L; Covelli, Margaret; Torpey, Miriam

    2010-01-01

    International nurses face a myriad of challenges in their transition, adaptation, and integration into the U.S. health care environment. This pilot intervention study examined socio-cultural competence regarding communication in a sample of international nurses working in two community hospitals in southern Nevada. Significant improvement in communication behaviors of the sampled international nurses with regard to socio-cultural skills of communication after the workshop intervention were not found. Similarly, there were no remarkable differences in standardized patient comments for most items on the checklist. However, the sampled international nurses demonstrated some highly desirable qualities such as being very personable, caring, and compassion that appeared to lay a foundation for an effective nurse-patient relationship.

  18. [Creating diagnoses and interventions under the auspices of different nursing classification systems].

    PubMed

    da Mata, Luciana Regina Ferreira; de Souza, Cristiane Chaves; Chianca, Tânia Couto Machado; de Carvalho, Emília Campos

    2012-12-01

    This study analyzes the use of different nursing classification systems to meet the standards established by the norm ISO 18.104:2003, based on a fictitious clinical situation. Nursing diagnoses and interventions were created using NANDA-I, NIC and ICNP® and an analysis was performed of the terminology agreement of these classification systems with the model proposed by the norm ISO 18.104:2003. For the creation of nursing diagnoses, NANDA-I and ICNP® comply with norm ISO 18.104:2003. As for the creation of nursing interventions, ICNP® meets the terminology reference model proposed by ISO 18104:2003. NIC, on the other hand, does not propose a combinatory terminology reference model. The unification of nursing terminology depends on reviewing, standardizing and testing these classifications in order to establish a common and sound language for the profession.

  19. Mapping a Decade of Physical Activity Interventions for Primary Prevention: A Protocol for a Scoping Review of Reviews

    PubMed Central

    Goertzen, Leah; Halas, Gayle; Rothney, Janet; Schultz, Annette SH; Wener, Pamela; Enns, Jennifer E

    2015-01-01

    Background Physical activity is a key behavioral component for the primary prevention of noncommunicable disease. The uptake of physical activity is influenced by individual and broader factors including social, economic, and environmental conditions. Objective The purpose of this paper is to describe a protocol for a scoping review of reviews (SRR) that aims to map a decade of research focused on physical activity interventions within the domain of primary prevention. Methods The 5 stages of our SRRs design were adapted from a seminal scoping review methodology. Our search strategy was developed for the following databases: SPORTDiscus, PubMed, Scopus, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Educational Resources Information Centre. Two reviewers (LG and AK) independently screened eligible studies and compared results to determine the final study selection. One reviewer will conduct the data extraction (LG); a second reviewer (AK) will assess the results to ensure comprehensiveness and accuracy of the scoping review synthesis. Results The SRRs will provide a broad overview of the physical activity research literature specific to primary prevention, and will describe key features of physical activity interventions. Potential gaps in the physical activity action areas will be identified, and thus, the results will inform future research directions. Conclusions This paper describes an innovative approach for comprehensively mapping an important topic’s research trends in the last decade. PMID:26215502

  20. Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses' hand washing.

    PubMed

    Fox, Cherie; Wavra, Teresa; Drake, Diane Ash; Mulligan, Debbie; Bennett, Yvonne Pacheco; Nelson, Carla; Kirkwood, Peggy; Jones, Louise; Bader, Mary Kay

    2015-05-01

    Critically ill patients are at marked risk of hospital-acquired infections, which increase patients' morbidity and mortality. Registered nurses are the main health care providers of physical care, including hygiene to reduce and prevent hospital-acquired infections, for hospitalized critically ill patients. To investigate a new patient hand hygiene protocol designed to reduce hospital-acquired infection rates and improve nurses' hand-washing compliance in an intensive care unit. A preexperimental study design was used to compare 12-month rates of 2 common hospital-acquired infections, central catheter-associated bloodstream infection and catheter-associated urinary tract infection, and nurses' hand-washing compliance measured before and during use of the protocol. Reductions in 12-month infection rates were reported for both types of infections, but neither reduction was statistically significant. Mean 12-month nurse hand-washing compliance also improved, but not significantly. A hand hygiene protocol for patients in the intensive care unit was associated with reductions in hospital-acquired infections and improvements in nurses' hand-washing compliance. Prevention of such infections requires continuous quality improvement efforts to monitor lasting effectiveness as well as investigation of strategies to eliminate these infections. ©2015 American Association of Critical-Care Nurses.

  1. Biofeedback Intervention for Stress, Anxiety, and Depression among Graduate Students in Public Health Nursing

    PubMed Central

    Kaewboonchoo, Orawan; Ratanasiripong, Nop; Hanklang, Suda; Chumchai, Pornlert

    2015-01-01

    Globally, graduate students have been found to have high prevalence of mental health problems. With increasing severity of mental health problems on university campuses and limited resources for mental health treatment, alternative interventions are needed. This study investigated the use of biofeedback training to help reduce symptoms of stress, anxiety, and depression. A sample of 60 graduate students in public health nursing was randomly assigned to either the biofeedback intervention or the control group. Results indicated that biofeedback intervention was effective in significantly reducing the levels of stress, anxiety, and depression over the 4-week period, while the control group had increases in symptoms of anxiety and depression over the same timeframe. As future leaders in the public health nursing arena, the more psychologically healthy the graduate students in public health nursing are, the better the public health nursing professionals they will be as they go forth to serve the community after graduation. PMID:25954515

  2. Nursing interventions in monitoring the adolescent with Cystic Fibrosis: a literature review

    PubMed Central

    Reisinho, Maria da Conceição Marinho Sousa Ribeiro Oliveira; Gomes, Bárbara Pereira

    2016-01-01

    ABSTRACT Objectives: to search for nursing interventions focused on the improvement of quality of life and promotion of self-care of adolescents suffering from the Cystic Fibrosis. Method: literature review. The inclusion criteria were: primary studies and studies with interventions developed by nurses in the adolescent population with Cystic Fibrosis, using Portuguese, Spanish, French and English with no time limit, and supported by the databases Scopus, Web of Science and CINAHL. The search expressions were: nursing AND care AND adolescent AND "Cystic Fibrosis" AND ("quality of life" OR "self-care"). Results: a total of 59 articles was retrieved; 8 matched the criteria chosen. Nursing interventions targeted at adolescents with Cystic Fibrosis and their family members were identified. These interventions were organized according to the nurses' role, namely caregiver, coordinator, counsellor, researcher, trainer and care partner. Conclusions: nursing interventions targeted at following up the adolescent during the entire therapeutic process, involving the presence of parents/significant others, since both the adolescent and family have to be responsible for self-care. Healthcare professionals should be capable of identifying the specific needs of patients with chronic disease and their family, permitting a better understanding and adaptation to the health-disease transition process. PMID:27982311

  3. The effect of a cultural competence educational intervention for first-year nursing students in Israel.

    PubMed

    Noble, Anita; Nuszen, Evelyn; Rom, Miriam; Noble, Lawrence M

    2014-01-01

    To evaluate the effectiveness of an educational intervention to increase general cultural competence of first-year nursing students. This was a quasi-experimental study that used a convenience sample with an experimental group and a control group and pre- and posttesting. The sample comprised 146 first-year nursing students enrolled in the Introduction to Nursing course divided into an intervention group (n = 58) of students from one school and a control group (n = 88) including students from two schools. The intervention group received a 2-hour faculty lecture on cultural competence, and students prepared and delivered a student group presentation about a cultural group in Israel, basing the presentation on Campinha-Bacote's five constructs. A demographic data instrument and Campinha-Bacote's Inventory for Assessing the Process of Cultural Competence Among Healthcare Professional-Revised© were used for pre- and posttesting. Students who received the educational intervention increased scores significantly (68 ± 6 to 73 ± 6, p = .000), students who did not receive the educational intervention had no significant increase (67 ± 6 to 66 ± 6). Introducing the topic of cultural competence for nursing students in the first-year Introduction to Nursing course as an integrative learning strategy revealed significant increases in cultural competence scores. Recommendations are to include evidence-based cultural competence teaching strategies into the nursing curriculum.

  4. Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.

    PubMed

    Ampe, Sophie; Sevenants, Aline; Coppens, Evelien; Spruytte, Nele; Smets, Tinne; Declercq, Anja; van Audenhove, Chantal

    2015-05-01

    To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. 'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers. © 2014 John Wiley & Sons Ltd.

  5. Occupational Stress Management and Burnout Interventions in Nursing and Their Implications for Healthy Work Environments: A Literature Review.

    PubMed

    Nowrouzi, Behdin; Lightfoot, Nancy; Larivière, Michael; Carter, Lorraine; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane

    2015-07-01

    This article reports on a literature review of workplace interventions (i.e., creating healthy work environments and improving nurses' quality of work life [QWL]) aimed at managing occupational stress and burnout for nurses. A literature search was conducted using the keywords nursing, nurses, stress, distress, stress management, burnout, and intervention. All the intervention studies included in this review reported on workplace intervention strategies, mainly individual stress management and burnout interventions. Recommendations are provided to improve nurses' QWL in health care organizations through workplace health promotion programs so that nurses can be recruited and retained in rural and northern regions of Ontario. These regions have unique human resources needs due to the shortage of nurses working in primary care.

  6. A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students.

    PubMed

    Gallagher, Ruth W; Polanin, Joshua R

    2015-02-01

    Increasing professional nurses' and nursing students cultural competence has been identified as one way to decrease the disparity of care for vulnerable and minority groups, but effectiveness of training programs to increase competence remains equivocal. The purpose of this project is to synthesize educational interventions designed to increase cultural competence in professional nurses and nursing students. A systematic review and meta-analysis was conducted to synthesize all existing studies on increasing cultural competence. A comprehensive search and screen procedures was conducted to locate all cultural competence interventions implemented with professional nurses and nursing students. Two independent researchers screened and coded the included studies. Effect sizes were calculated for each study and a random-effects meta-analysis was conducted. A total of 25 studies were included in the review. Two independent syntheses were conducted given the disparate nature of the effect size metrics. For the synthesis of treatment-control designed studies, the results revealed a non-statistically significant increase in cultural competence (g¯=.38, 95% CI: -.05, .79, p=.08). Moderator analyses indicated significant variation as a function of the measurements, participant types, and funding source. The pretest-posttest effect size synthesis revealed a significant increase in overall cultural competence (g¯=.45, 95% CI: .24, .66, p<.01). Moderator analyses indicated, however, that the effect sizes varied as functions of the measurement, funding source, and publication type. Interventions to increase cultural competence have shown varied effectiveness. Greater research is required to improve these interventions and promote cultural competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later.

    PubMed

    Griffin, Martha; Clark, Cynthia M

    2014-12-01

    Ten years ago, Griffin wrote an article on the use of cognitive rehearsal as a shield for lateral violence. Since then, cognitive rehearsal has been used successfully in several studies as an evidence-based strategy to address uncivil and bullying behaviors in nursing. In the original study, 26 newly licensed nurses learned about lateral violence and used cognitive rehearsal techniques as an intervention for nurse-to-nurse incivility. The newly licensed nurses described using the rehearsed strategies as difficult, yet successful in reducing or eliminating incivility and lateral violence. This article updates the literature on cognitive rehearsal and reviews the use of cognitive rehearsal as an evidence-based strategy to address incivility and bullvina behaviors in nursing.

  8. Helping nurses cope with grief and compassion fatigue: an educational intervention.

    PubMed

    Houck, Dereen

    2014-08-01

    Oncology nurses may experience intense physical and emotional exhaustion, identified in the literature as symptoms of cumulative grief and compassion fatigue, with significant consequences for both nurses and organizations. The first step in preventing these consequences is recognition. Organizations should provide nurses with resources including education, counseling, and opportunities to grieve. Nurses need to learn the importance of work-life balance, self-care strategies, and communication skills. Using recommendations from the literature, an educational intervention was designed with the purpose of providing nurses with knowledge, skills, and resources to practice effective self-care and recognize when assistance is needed. The program's objective was to help nurses develop the coping skills and inner resources necessary to maintain their emotional and physical health.

  9. Assessment of an educational intervention based on constructivism in nursing students from a Mexican public university.

    PubMed

    Jiménez Trujano, Laura; Morán Peña, Laura

    2015-12-01

    This work sought to evaluate the effect of an educational intervention centered on the analysis of clinical cases to inquire on conceptual learning in students on the theme of nursing care of women with complicated puerperium. This was a quasi-experimental study with before and after evaluation. Two groups of students participated from the eighth semester of the nursing program, which professionalized individuals who were already nursing technicians: the study group (n = 33) was taught the theme of nursing care to women with complicated puerperium with the case analysis technique and the control group (n = 27) received traditional teaching. A self-applied question here was used related to the thematic unit, which included three clinical cases and the resolution of a total of 37 questions related to set cases. This questionnaire was the same applied before and after the intervention. The pre-intervention mean score was similar in both groups (26 during the study and 27 during the intervention). Upon completing the educational intervention, the post-intervention scores were equal in both groups (27 points). The intra-group analysis showed that in the study group the intervention produced a slight change in conceptual learning, which was statistically significant. During the post-hoc analysis differences in scores were found in students who worked in hospitals with tier three level of care. Educational intervention favored conceptual learning slightly in the study group. It is necessary to explore other intervening variables that propitiate this learning in the program.

  10. A School Nurse-Delivered Intervention for Overweight and Obese Adolescents

    ERIC Educational Resources Information Center

    Pbert, Lori; Druker, Susan; Gapinski, Mary A.; Gellar, Lauren; Magner, Robert; Reed, George; Schneider, Kristin; Osganian, Stavroula

    2013-01-01

    Background: Models are needed for implementing weight management interventions for adolescents through readily accessible venues. This study evaluated the feasibility and ef?cacy of a school nurse-delivered intervention in improving diet and activity and reducing body mass index (BMI) among overweight and obese adolescents. Methods: Six high…

  11. Exploratory Research to Design a School Nurse-Delivered Intervention to Treat Adolescent Overweight and Obesity

    ERIC Educational Resources Information Center

    Gellar, Lauren; Druker, Sue; Osganian, Stavroula K.; Gapinski, Mary Ann; LaPelle, Nancy; Pbert, Lori

    2012-01-01

    Objective: In preparation for a pilot study to evaluate the efficacy of a school nurse-delivered intervention, focus groups were conducted to gain insight into the perceptions of stakeholders regarding the design and implementation of the intervention. Setting and Participants: Fifteen focus groups at participating schools. One hundred subjects,…

  12. Exploratory Research to Design a School Nurse-Delivered Intervention to Treat Adolescent Overweight and Obesity

    ERIC Educational Resources Information Center

    Gellar, Lauren; Druker, Sue; Osganian, Stavroula K.; Gapinski, Mary Ann; LaPelle, Nancy; Pbert, Lori

    2012-01-01

    Objective: In preparation for a pilot study to evaluate the efficacy of a school nurse-delivered intervention, focus groups were conducted to gain insight into the perceptions of stakeholders regarding the design and implementation of the intervention. Setting and Participants: Fifteen focus groups at participating schools. One hundred subjects,…

  13. Evaluation of a Cultural Competence Intervention with Implications for the Nurse-Patient Encounter

    ERIC Educational Resources Information Center

    Bradford, Althea Betty

    2012-01-01

    A short-term intervention on participants' knowledge of cultural competence was provided to 38 students in a baccalaureate nursing program at Winston-Salem State University (WSSU). The study examined the effectiveness of this intervention. Although WSSU is a Historically Black University, the majority of students in this program were White. Six…

  14. A School Nurse-Delivered Intervention for Overweight and Obese Adolescents

    ERIC Educational Resources Information Center

    Pbert, Lori; Druker, Susan; Gapinski, Mary A.; Gellar, Lauren; Magner, Robert; Reed, George; Schneider, Kristin; Osganian, Stavroula

    2013-01-01

    Background: Models are needed for implementing weight management interventions for adolescents through readily accessible venues. This study evaluated the feasibility and ef?cacy of a school nurse-delivered intervention in improving diet and activity and reducing body mass index (BMI) among overweight and obese adolescents. Methods: Six high…

  15. Evaluation of a Cultural Competence Intervention with Implications for the Nurse-Patient Encounter

    ERIC Educational Resources Information Center

    Bradford, Althea Betty

    2012-01-01

    A short-term intervention on participants' knowledge of cultural competence was provided to 38 students in a baccalaureate nursing program at Winston-Salem State University (WSSU). The study examined the effectiveness of this intervention. Although WSSU is a Historically Black University, the majority of students in this program were White. Six…

  16. Interventions to promote or improve the mental health of primary care nurses: a systematic review.

    PubMed

    Duhoux, Arnaud; Menear, Matthew; Charron, Maude; Lavoie-Tremblay, Mélanie; Alderson, Marie

    2017-08-06

    To synthesize the evidence on the effectiveness of interventions aiming to promote or improve the mental health of primary care nurses. Primary care nurses have been found to have high levels of emotional exhaustion and to be at increased risk of suffering from burnout, anxiety and depression. Given the increasingly critical role of nurses in high-performing primary care, there is a need to identify interventions that can effectively reduce these professionals' mental health problems and promote their well-being. We conducted a systematic review on the effectiveness of interventions at the individual, group, work environment or organizational level. Eight articles reporting on seven unique studies met all eligibility criteria. They were non-randomized pre-post intervention studies and reported positive impacts of interventions on at least some outcomes, though caution is warranted in interpreting these results given the moderate-weak methodological quality of studies. This systematic review found moderate-weak evidence that primary, secondary and combined interventions can reduce burnout and stress in nurses practising in community-based health care settings. The results highlight a need for the implementation and evaluation of new strategies tailored for community-based nurses practising in primary care. © 2017 John Wiley & Sons Ltd.

  17. Home nurses and patient depression. Attitudes, competences and the effects of a minimal intervention.

    PubMed

    Van Daele, Tom; Vansteenwegen, Debora; Hermans, Dirk; Van den Bergh, Omer; Van Audenhove, Chantal

    2015-01-01

    To explore attitudes and confidence in professional competence of home nurses concerning depression and to evaluate the capacity of a minimal intervention in helping home nurses to detect depression in patients and their family caregivers. Long-term ill patients have an elevated risk to develop comorbid depression, as do their family caregivers. However, most primary care providers have little training to detect patients at risk. A minimal intervention to help home nurses detect symptoms of depression was therefore evaluated. Quasi-experimental field study with pre-measures, postmeasures and follow-up measures. From the Fall of 2012-Spring of 2013, home nurses (N = 92) in three regions in Antwerp (Belgium) were assigned to a 1-hour intervention (consisting of information, skill training and discussion; N = 63) or to a control condition (N = 29). The Depression Attitude Questionnaire and the Morris Confidence Scale were completed before the intervention and 3 and 7 months afterwards. For 3 months, the number of detections of depression in patients in each region was monitored. No significant changes were found in attitude or confidence in professional competences, except for a decline in the role attitude for home nurses in the intervention group. Home nurses who followed the intervention did detect significantly more depressed patients compared with controls. These findings suggest that a minimal intervention can allow home nurses to be more responsive to symptoms of depression in patients and their family caregivers. The implications of these findings are discussed and suggestions for future research are made. © 2014 John Wiley & Sons Ltd.

  18. Restoring the spirit at the end of life: music as an intervention for oncology nurses.

    PubMed

    Halstead, Marilyn Tuls; Roscoe, Sherry Tuls

    2002-01-01

    Music is a useful therapeutic intervention that can improve quality of life for dying patients. Physiologic mechanisms in response to carefully chosen musical selections help to alleviate pain, anxiety, and nausea and induce sleep. Expression of feelings enhances mood. Palliative care nurses increase the effectiveness of this intervention through careful assessment of patient needs, preferences, goals of intervention, and available resources. Music, a universal language, is an important clinical adjunct that addresses individual and family needs, thereby assisting patients to achieve a peaceful death. This article explores musical categories of preferences to assist nurses, patients, and families in choosing music that meets specific therapeutic objectives.

  19. Registered nurses' clinical reasoning in home healthcare clinical practice: A think-aloud study with protocol analysis.

    PubMed

    Johnsen, Hege Mari; Slettebø, Åshild; Fossum, Mariann

    2016-05-01

    The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. An exploratory qualitative think-aloud design with protocol analysis was used. Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. A purposeful sample of eight registered nurses with one year of experience. Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Nurse-based case management for aged patients with myocardial infarction: study protocol of a randomized controlled trial

    PubMed Central

    2010-01-01

    Background Aged patients with coronary heart disease (CHD) have a high prevalence of co-morbidity associated with poor quality of life, high health care costs, and increased risk for adverse outcomes. These patients are often lacking an optimal home care which may result in subsequent readmissions. However, a specific case management programme for elderly patients with myocardial infarction (MI) is not yet available. The objective of this trial is to examine the effectiveness of a nurse-based case management in patients aged 65 years and older discharged after treatment of an acute MI in hospital. The programme is expected to influence patient readmission, mortality and quality of life, and thus to reduce health care costs compared with usual care. In this paper the study protocol is described. Methods/design The KORINNA (Koronarinfarkt Nachbehandlung im Alter) study is designed as a single-center randomized two-armed parallel group trial. KORINNA is conducted in the framework of KORA (Cooperative Health Research in the Region of Augsburg). Patients assigned to the intervention group receive a nurse-based follow-up for one year including home visits and telephone calls. Key elements of the intervention are to detect problems or risks, to give advice regarding a broad range of aspects of disease management and to refer to the general practitioner, if necessary. The control group receives usual care. Twelve months after the index hospitalization all patients are re-assessed. The study has started in September 2008. According to sample size estimation a total number of 338 patients will be recruited. The primary endpoint of the study is time to first readmission to hospital or out of hospital death. Secondary endpoints are functional status, participation, quality of life, compliance, and cost-effectiveness of the intervention. For the economic evaluation cost data is retrospectively assessed by the patients. The incremental cost-effectiveness ratio (ICER) will be

  1. Nutrition education intervention for dependent patients: protocol of a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Malnutrition in dependent patients has a high prevalence and can influence the prognosis associated with diverse pathologic processes, decrease quality of life, and increase morbidity-mortality and hospital admissions. The aim of the study is to assess the effect of an educational intervention for caregivers on the nutritional status of dependent patients at risk of malnutrition. Methods/Design Intervention study with control group, randomly allocated, of 200 patients of the Home Care Program carried out in 8 Primary Care Centers (Spain). These patients are dependent and at risk of malnutrition, older than 65, and have caregivers. The socioeconomic and educational characteristics of the patient and the caregiver are recorded. On a schedule of 0–6–12 months, patients are evaluated as follows: Mini Nutritional Assessment (MNA), food intake, dentures, degree of dependency (Barthel test), cognitive state (Pfeiffer test), mood status (Yesavage test), and anthropometric and serum parameters of nutritional status: albumin, prealbumin, transferrin, haemoglobin, lymphocyte count, iron, and ferritin. Prior to the intervention, the educational procedure and the design of educational material are standardized among nurses. The nurses conduct an initial session for caregivers and then monitor the education impact at home every month (4 visits) up to 6 months. The North American Nursing Diagnosis Association (NANDA) methodology will be used. The investigators will study the effect of the intervention with caregivers on the patient’s nutritional status using the MNA test, diet, anthropometry, and biochemical parameters. Bivariate normal test statistics and multivariate models will be created to adjust the effect of the intervention. The SPSS/PC program will be used for statistical analysis. Discussion The nutritional status of dependent patients has been little studied. This study allows us to know nutritional risk from different points of view: diet

  2. Nutrition education intervention for dependent patients: protocol of a randomized controlled trial.

    PubMed

    Arija, Victoria; Martín, Núria; Canela, Teresa; Anguera, Carme; Castelao, Ana I; García-Barco, Montserrat; García-Campo, Antoni; González-Bravo, Ana I; Lucena, Carme; Martínez, Teresa; Fernández-Barrés, Silvia; Pedret, Roser; Badia, Waleska; Basora, Josep

    2012-05-24

    Malnutrition in dependent patients has a high prevalence and can influence the prognosis associated with diverse pathologic processes, decrease quality of life, and increase morbidity-mortality and hospital admissions.The aim of the study is to assess the effect of an educational intervention for caregivers on the nutritional status of dependent patients at risk of malnutrition. Intervention study with control group, randomly allocated, of 200 patients of the Home Care Program carried out in 8 Primary Care Centers (Spain). These patients are dependent and at risk of malnutrition, older than 65, and have caregivers. The socioeconomic and educational characteristics of the patient and the caregiver are recorded. On a schedule of 0-6-12 months, patients are evaluated as follows: Mini Nutritional Assessment (MNA), food intake, dentures, degree of dependency (Barthel test), cognitive state (Pfeiffer test), mood status (Yesavage test), and anthropometric and serum parameters of nutritional status: albumin, prealbumin, transferrin, haemoglobin, lymphocyte count, iron, and ferritin.Prior to the intervention, the educational procedure and the design of educational material are standardized among nurses. The nurses conduct an initial session for caregivers and then monitor the education impact at home every month (4 visits) up to 6 months. The North American Nursing Diagnosis Association (NANDA) methodology will be used. The investigators will study the effect of the intervention with caregivers on the patient's nutritional status using the MNA test, diet, anthropometry, and biochemical parameters.Bivariate normal test statistics and multivariate models will be created to adjust the effect of the intervention.The SPSS/PC program will be used for statistical analysis. The nutritional status of dependent patients has been little studied. This study allows us to know nutritional risk from different points of view: diet, anthropometry and biochemistry in dependent patients at

  3. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol.

    PubMed

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z; Levin, Frances R

    2014-10-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.

  4. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

    PubMed Central

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

    2014-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

  5. Are nurse-conducted brief interventions (NCBIs) efficacious for hazardous or harmful alcohol use? A systematic review.

    PubMed

    Joseph, J; Basu, D; Dandapani, M; Krishnan, N

    2014-06-01

    The aim of this study was to compare the efficacy of nurse-conducted brief interventions in reducing alcohol consumption, by looking at with treatment as usual compared with other treatments and general physician-delivered brief interventions within the literature. Globally, the consumption of alcohol is at a worrying level and has significant effects on health when consumed to excess. Numerous studies have reported that brief intervention is effective in reducing excessive drinking. However, evidence on the efficacy of such interventions by nurses is still inconclusive. We included randomized controlled trials of brief interventions in which nurses were primarily involved as therapists, and were designed to achieve a reduction in alcohol consumption and related problems. We used online searches to locate randomized controlled trials in this area published from 1995 till 2012. Eleven trials were found meeting inclusion criteria, comparing nurse-conducted brief interventions with a control group or with other treatments. Five trials reported a statistically significant reduction in alcohol consumption in the intervention group with 6-12-month follow-up period and two trials concluded that brief interventions delivered by nurses was as efficacious as by physicians. The findings of the review have important policy implications for the preparation of nurses as therapists for brief interventions to reduce excessive drinking in a broad range of settings such as primary healthcare and hospital settings. The adoption of this intervention into contemporary nursing practice should be considered by the International Council of Nurses and nurses around the world as, according to the literature, it provides an evidence base for the independent functioning of nurses within the realms of nursing profession and addiction medicine. The results of the review suggest that nurse-conducted brief interventions are an effective strategy for reducing alcohol consumption. We advocate more

  6. Evaluating nurses' implementation of an infant-feeding counseling protocol for HIV-infected mothers: The Ban Study in Lilongwe, Malawi.

    PubMed

    Ferguson, Yvonne Owens; Eng, Eugenia; Bentley, Margaret; Sandelowski, Margarete; Steckler, Allan; Randall-David, Elizabeth; Piwoz, Ellen G; Zulu, Cynthia; Chasela, Charles; Soko, Alice; Tembo, Martin; Martinson, Francis; Tohill, Beth Carlton; Ahmed, Yusuf; Kazembe, Peter; Jamieson, Denise J; van der Horst, Charles; Adair, Linda; Ahmed, Yusuf; Ait-Khaled, Mounir; Albrecht, Sandra; Bangdiwala, Shrikant; Bayer, Ronald; Bentley, Margaret; Bramson, Brian; Bobrow, Emily; Boyle, Nicola; Butera, Sal; Chasela, Charles; Chavula, Charity; Chimerang'ambe, Joseph; Chigwenembe, Maggie; Chikasema, Maria; Chikhungu, Norah; Chilongozi, David; Chiudzu, Grace; Chome, Lenesi; Cole, Anne; Corbett, Amanda; Corneli, Amy; Duerr, Ann; Eliya, Henry; Ellington, Sascha; Eron, Joseph; Farr, Sherry; Ferguson, Yvonne Owens; Fiscus, Susan; Galvin, Shannon; Guay, Laura; Heilig, Chad; Hoffman, Irving; Hooten, Elizabeth; Hosseinipour, Mina; Hudgens, Michael; Hurst, Stacy; Hyde, Lisa; Jamieson, Denise; Joaki, George; Jones, David; Kacheche, Zebrone; Kamanga, Esmie; Kamanga, Gift; Kampani, Coxcilly; Kamthunzi, Portia; Kamwendo, Deborah; Kanyama, Cecilia; Kashuba, Angela; Kathyola, Damson; Kayira, Dumbani; Kazembe, Peter; Knight, Rodney; Kourtis, Athena; Krysiak, Robert; Kumwenda, Jacob; Loeliger, Edde; Luhanga, Misheck; Madhlopa, Victor; Majawa, Maganizo; Maida, Alice; Marcus, Cheryl; Martinson, Francis; Thoofer, Navdeep; Matika, Chrissie; Mayers, Douglas; Mayuni, Isabel; McDonough, Marita; Meme, Joyce; Merry, Ceppie; Mita, Khama; Mkomawanthu, Chimwemwe; Mndala, Gertrude; Mndala, Ibrahim; Moses, Agnes; Msika, Albans; Msungama, Wezi; Mtimuni, Beatrice; Muita, Jane; Mumba, Noel; Musis, Bonface; Mwansambo, Charles; Mwapasa, Gerald; Nkhoma, Jacqueline; Pendame, Richard; Piwoz, Ellen; Raines, Byron; Ramdas, Zane; Rublein, John; Ryan, Mairin; Sanne, Ian; Sellers, Christopher; Shugars, Diane; Sichali, Dorothy; Snowden, Wendy; Soko, Alice; Spensley, Allison; Steens, Jean-Marc; Tegha, Gerald; Tembo, Martin; Thomas, Roshan; Tien, Hsiao-Chuan; Tohill, Beth; van der Horst, Charles; Waalberg, Esther; Wiener, Jeffrey; Wilfert, Cathy; Wiyo, Patricia; Zgambo, Onnocent; Zimba, Chifundo

    2009-04-01

    A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes.

  7. Contrast-Induced Acute Kidney Injury: Specialty-Specific Protocols for Interventional Radiology, Diagnostic Computed Tomography Radiology, and Interventional Cardiology

    PubMed Central

    Goldfarb, Stanley; McCullough, Peter A.; McDermott, John; Gay, Spencer B.

    2009-01-01

    Contrast-induced acute kidney injury (AKI) (also known as contrast-induced nephropathy) is an abrupt deterioration in renal function that can be associated with use of iodinated contrast medium. Although the increase in serum creatinine concentration is transient in most cases, contrast-induced AKI may lead to increased morbidity and mortality rates in selected at-risk populations. This review summarizes the findings of a multidisciplinary panel composed of computed tomography radiologists, interventional radiologists, cardiologists, and nephrologists convened to address the specialty-specific issues associated with minimizing the incidence of contrast-induced AKI. As part of this initiative, the panel developed specialty-specific protocols for preventing contrast-induced AKI, taking into account, for example, the variations in patient risk profile, inpatient or outpatient status, and staffing resources that characterize various clinical settings. The 3 protocols, each reflecting a consensus of expert opinion, address the prevention of contrast-induced AKI in interventional radiology, diagnostic computed tomography radiology, and interventional cardiology settings. The protocols are presented in the context of a review of recent guidelines and published reports of trials that discuss contrast-induced AKI and its prevention. The panel reviewed materials retrieved by a PubMed search covering the period January 1990 through January 2008 and used combinations of key words associated with the prevention and treatment of contrast-induced AKI. In addition, the panel reviewed the reference lists of selected articles and the tables of contents posted on the Web sites of selected journals for relevant publications not retrieved in the PubMed searches. PMID:19181651

  8. Nursing Intervention Classifications (NIC) validated for patients at risk of pressure ulcers.

    PubMed

    Bavaresco, Taline; Lucena, Amália de Fátima

    2012-01-01

    to validate the Nursing Intervention Classifications (NIC) for the diagnosis 'Risk of Impaired Skin Integrity' in patients at risk of pressure ulcers (PU). the sample comprised 16 expert nurses. The data was collected with an instrument about the interventions and their definitions were scored on a Likert scale by the experts. The data was analyzed statistically, using the calculation of weighted averages (WA). The study was approved by the Research Ethics Committee (56/2010). nine interventions were validated as 'priority' (WA ≥0.80), among them Prevention of PU (MP=0.92); 22 as 'suggested' (WA >0.50 and <0.80) and 20 were discarded (WA ≤0.50). the prevention of PU results from the implementation of specific interventions related to the risk factors for development of the lesion, with implications for nursing practice, teaching and research.

  9. The role of nurse support within an Internet-delivered weight management intervention: A qualitative study.

    PubMed

    Renouf, Sarah; Bradbury, Katherine; Yardley, Lucy; Little, Paul

    2015-01-01

    This qualitative study explored patients' experiences of nurse support for an Internet-delivered weight management intervention. Eighteen patients who had received either basic or regular nurse support (three or seven contacts, respectively) for the Internet intervention were interviewed. The data were analysed using thematic analysis. The findings suggest that more regular support for Internet interventions may have the potential to inhibit the development of autonomous motivation for weight loss, which might lead to problems in sustaining losses after support ends. Further research is now needed to confirm whether motivation is influenced by frequency of nurse support in Internet interventions in order to inform the development of optimal support which promotes sustained weight loss.

  10. Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care.

    PubMed

    Caine, Vera; Mill, Judy; O'Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

    2016-01-01

    We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations.

  11. Telephone interventions by nursing students: improving outcomes for heart failure patients in the community.

    PubMed

    Wheeler, Erlinda C; Waterhouse, Julie K

    2006-01-01

    Community care for heart failure patients is difficult due to multiple comorbidities, polypharmacy, and advanced age of patients. Studies show that hospital admissions and emergency room visits decrease with increased nursing interventions in home and community settings. The purpose of this study(1) was to assess the effectiveness of regular telephone interventions by nursing students on outcomes of heart failure patients in the home. Senior students were paired with community nursing staff and assigned 2 heart failure patients to follow up by telephone calls for 12 to 14 weeks. Patients who received telephone interventions had fewer hospital readmissions (13%) than the comparison group (35%). Patients in the telephone intervention group also had fewer overt heart failure symptoms as measured by the Minnesota Living With Heart Failure Questionnaire.

  12. Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care

    PubMed Central

    Caine, Vera; Mill, Judy; O’Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

    2016-01-01

    We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations. PMID:26644019

  13. Evidence-based nurse-driven interventions for the care of newborns with neonatal abstinence syndrome.

    PubMed

    Casper, Tammy; Arbour, Megan

    2014-12-01

    Neonatal abstinence syndrome (NAS) is a growing problem in the United States, related to increased maternal substance use and abuse, and a set of drug withdrawal symptoms that can affect the central nervous system and gastrointestinal and respiratory systems in the newborn when separated from the placenta at birth. Infants with NAS often require a significant length of stay in the neonatal intensive care unit (NICU). Pharmacologic treatments and physician-directed interventions are well researched, but nursing-specific interventions and recommendations are lacking. A thorough review and analysis of the literature and interviews with neonatal experts guided the development of a nursing clinical practice guideline for infants with NAS in a level IV NICU. Recommended nursing-specific interventions include methods for maternal drug-use identification, initiation and timing of the Finnegan Scoring System to monitor withdrawal symptoms, and bedside interventions to lessen the drug-withdrawal symptoms in the newborn with NAS.

  14. Child development surveillance: intervention study with nurses of the Family Health Strategy1

    PubMed Central

    Reichert, Altamira Pereira da Silva; Collet, Neusa; Eickmann, Sophie Helena; Lima, Marília de Carvalho

    2015-01-01

    Objective: to evaluate the effectiveness of an educational action in child development surveillance performed by nurses working in primary health care. Methods: interventional study with a before-and-after type of design, carried out with 45 nurses and 450 mothers of children under 2 years of age. Initially, it was evaluated the practices and knowledge of nurses on child development surveillance and the mothers were interviewed about these practices. Subsequently, workshops were carried out with nurses and four months later, the knowledge of nurses and the maternal information were reevaluated. Results: after intervention there was significant increase in the frequency of the following aspects: from 73% to 100%, in relation to the practice of nurses of asking the opinion of mothers about their children's development; from 42% to 91%, regarding the use of the systematized instrument of evaluation; from 91% to 100% with respect to guidance to mothers on how to stimulate child development. Conclusions: the intervention contributed to the increase of knowledge of nurses and implementation of child development surveillance, showing the importance of this initiative to improve the quality of child health care. PMID:26487147

  15. TCM comprehensive nursing intervention to pathological jaundice on neonate.

    PubMed

    Li, Jie; Chen, Weihua; Xu, Guihua

    2016-11-01

    Pathological Jaundice on neonate differs from that of physiologic jaundice. They perform differently on clinical cases, which is an effective way to distinguish them. There are many causes for pathological jaundice, common ones include hemolytic jaundice, infectious jaundice, obstructive jaundice, breast-feeding jaundice, etc. Clinically proven that pathological jaundices has significant differences in symptoms. This brings problems to its treatment and nursing. In recent years, TCM comprehensive nursing shows great results in treating process. Therefore, this paper take 2000 cases to make a thorough analysis for the actual clinical effects of TCM comprehensive nursing on pathological jaundice on neonate.

  16. A student nurse experience of an intervention that addresses the perioperative nursing shortage.

    PubMed

    Monahan, J Carter

    2015-11-01

    Registered nurses are the largest group of professionals in the global healthcare system. The number of nurses is estimated to be 19.3 million throughout the world (Flinkman et al 2013). In the United States the need for registered nurses is growing. It has been predicted that 260,000 positions for registered nurses will remain unfilled by the year 2025 (Harris et al 2014) with a shortage of registered nurses projected to spread across the United States between 2009 and 2030 (Juraschek et al 2012). Compounding the projected nursing shortage is the increased attrition rate, which is as high as 61% within the first year (Pine & Tart 2007). There are several reasons for this shortage including supply and demand issues, projected changes to healthcare and the aging population. Additionally, the number of college graduates who have majored in nursing has not met the demand (Dunn 2014).

  17. Incivility among intensive care nurses: the effects of an educational intervention.

    PubMed

    Nikstaitis, Teresa; Simko, Lynn Coletta

    2014-01-01

    Incivility is a significant problem in nurse satisfaction and nurse retention and can be detrimental to a patient's outcome; therefore, it would be beneficial to educate nurses on ways to improve incivility in clinical practice. To determine if a nursing education program, utilizing case studies and discussion of the nurses' experiences would increase awareness of incivility and impact the number of perceived incidences by (1) assessing nurses' experience of incivility along with discerning the perceived source of the incivility and (2) educating the nurses, thus determining if the in-service education decreases the incidence of incivility in the adult intensive care unit. This is a quantitative pilot study that utilized a 1-group preintervention and postintervention test design. The intervention was a 60-minute educational program. Twenty-one nurses completed the survey that assesses prevalence of incivility by specific sources, such as nurses, physicians, supervisors, general (other hospital employees), and patients before and after participation in the education intervention. Descriptive statistics of the 5 dimensions of civility and a total dimension score of civility were used. A total of 21 nurses completed all parts of this study. The postintervention score had a higher mean than the preintervention score in each of the dimensions. Higher scores indicate incivility; thus, lower scores indicate civility. Therefore, more instances of incivility were identified after intervention to increase awareness of incivility. In addition, nurses perceived greater amounts of incivility from patients and families, whereas the direct supervisor (team leaders) showed the greatest amount of civility. A hierarchical regression revealed that race had the largest negative impact, followed by nurses practicing for more than 5 years, part-time status, and younger age, respectively. The outcomes in this pilot study contradict much of the research on incivility in nursing, which

  18. An integrative literature review of interventions to reduce violence against emergency department nurses.

    PubMed

    Anderson, Linda; FitzGerald, Mary; Luck, Lauretta

    2010-09-01

    To critique the evidence that underpins interventions intended to minimise workplace violence directed against emergency department nurses, to inform researchers and policy makers regarding the design, development, implementation and evaluation of emergency nursing anti-violence and counter-violence interventions. Workplace violence perpetrated against emergency department nurses is at least continuing and at worst increasing. Occupational violence has detrimental effects on job satisfaction, retention and recruitment, and the quality and cost of patient care. An integrated literature review. Searches of the Cochrane Library, CINAHL, MEDLINE and the Joanna Briggs Institute between 1986-May 2007. Included articles were appraised and then synthesised into a narrative summary. Ten primary research studies were included. Interventions were classified as environmental, practices and policies, or skills. While each study has useful information regarding the implementation of interventions, there is no strong evidence for their efficacy. The weight of effort is still directed towards defining the phenomenon rather than addressing solutions. Studies that assessed the efficacy of a single intervention failed to take account of context; and participatory context-driven studies failed to provide generalisable evidence. Concerted multi-site and multi-disciplinary, action-oriented research studies are urgently needed to provide an evidence base for the prevention and mitigation of violence perpetrated against emergency department nurses. The investigation of interventions rather than repeatedly redefining the problem and directing resources into debating semantics or differentiating 'degrees' of violence and aggression is recommended. This review unambiguously identifies the gap in research-based interventions. © 2010 Blackwell Publishing Ltd.

  19. Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

    PubMed Central

    Wartha, Olivia; Dreyhaupt, Jens; Lämmle, Christine; Friedemann, Eva-Maria; Kelso, Anne; Kutzner, Claire; Hermeling, Lina

    2017-01-01

    Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089. PMID:28303253

  20. The Self-care Educational Intervention for Patients With Heart Failure: A Study Protocol.

    PubMed

    Boyde, Mary; Peters, Robyn; Hwang, Rita; Korczyk, Dariusz; Ha, Tina; New, Nicole

    A variety of educational interventions have been implemented to assist patients with heart failure (HF) to maintain their own health, develop self-care behaviors, and decrease readmissions. The most effective approach to education has yet to be established. The aim of this study is to determine the effectiveness of a multimedia educational intervention for patients with HF in reducing hospital readmissions. Secondary outcomes include changes in knowledge and self-care behaviors. A randomized controlled trial in a large tertiary referral hospital in Australia has recruited 200 patients and will follow them for 12 months. Patients diagnosed with HF have been randomly allocated 1:1 to either usual education or a multimedia educational intervention. Framed by the principles of adult learning, this individualized intervention was delivered face to face by a specialized HF nurse, with a targeted educational assessment and subsequent development of an educational plan. The multimedia approach combined viewing a DVD and verbal discussion supported by a written manual. The teach-back strategy at the conclusion of the intervention evaluated the patient's learning through 5 key questions about self-management of HF. Readmissions are assessed at 28 days, 3 months, and 12 months. Knowledge and self-care behavior are assessed at baseline, 3 months, and 12 months. This study evaluates the effectiveness of a targeted multimedia educational intervention. Study results may inform the design of in-hospital education for HF patients.

  1. Increasing nurse staffing levels in Belgian cardiac surgery centres: a cost-effective patient safety intervention?

    PubMed

    Van den Heede, Koen; Simoens, Steven; Diya, Luwis; Lesaffre, Emmanuel; Vleugels, Arthur; Sermeus, Walter

    2010-06-01

    This paper is a report of a cost-effectiveness analysis from a hospital perspective of increased nurse staffing levels (to the level of the 75th percentile) in Belgian general cardiac postoperative nursing units. A previous study indicated that increasing nurse staffing levels in Belgian general cardiac postoperative nursing units was associated with lower mortality rates. Research is needed to compare the costs of increased nurse staffing levels with benefits of reducing mortality rates. Two types of average national costs were compared. A first calculation included the simulation of an increase in the number of nursing hours per patient day to the 75th percentile for nursing units staffed below that level. For the second calculation (the comparator) we used a 'do nothing' alternative. The most recent available data sources were used for the analysis. Results were expressed in the form of the additional costs per avoided death and the additional costs per life-year gained. The analysis used 2007 costing data. The costs of increasing nurse staffing levels to the 75th percentile in Belgian general cardiac postoperative nursing units amounted to euro1,211,022. Such nurse staffing levels would avoid an estimated number of 45.9 (95% confidence interval: 22.0-69.4) patient deaths per year and generate 458.86 (95% confidence interval: 219.93-693.79) life-years gained annually. This corresponds with incremental cost-effectiveness ratios of euro26,372 per avoided death and euro2639 per life-year gained. Increasing nurse staffing levels appears to be a cost-effective intervention as compared with other cardiovascular interventions.

  2. The immediate post-operative period following lung transplantation: mapping of nursing interventions

    PubMed Central

    Duarte, Rayssa Thompson; Linch, Graciele Fernanda da Costa; Caregnato, Rita Catalina Aquino

    2014-01-01

    OBJECTIVES: to investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC) taxonomy. METHOD: retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012). The data of the patients' profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded. RESULTS: the majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6%) were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses. CONCLUSIONS: it was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy. PMID:25493673

  3. Therapeutic enhancement: nursing intervention category for patients diagnosed with Readiness for Therapeutic Regimen Management.

    PubMed

    Kelly, Cynthia W

    2008-04-01

    To present a new nursing intervention category called therapeutic enhancement. Fewer than half of North Americans follow their physician's recommendations for diet and exercise, even when such are crucial to their health or recovery. It is imperative that nurses consider new ways to promote healthy behaviours. Therapeutic enhancement is intended to provide such a fresh approach. Traditional intervention techniques focusing on education, contracts, social support and more frequent interaction with physicians appear not to be effective when used alone. Successful strategies have been multidisciplinary; and have included interventions by professional nurses who assist patients to understand their disease and the disease process and that helps them to develop disease-management and self-management skills. Therapeutic enhancement incorporates The Stages of Change Theory, Commitment to Health Theory, Motivational Interviewing techniques and instrumentation specifically designed for process evaluation of health-promoting interventions. This is a critical review of approaches that, heretofore, have not been synthesised in a single published article. Based on the commonly used Stages of Change model, therapeutic enhancement is useful for patients who are at the action stage of change. Using therapeutic enhancement as well as therapeutic strategies identified in Stages of Change Theory, such as contingency management, helping relationships, counterconditioning, stimulus control and Motivational Interviewing techniques, nursing professionals can significantly increase the chances of patients moving from action to the maintenance stage of change for a specific health behaviour. Using the nursing intervention category, therapeutic enhancement can increase caregivers' success in helping patients maintain healthy behaviours.

  4. The immediate post-operative period following lung transplantation: mapping of nursing interventions.

    PubMed

    Duarte, Rayssa Thompson; Linch, Graciele Fernanda da Costa; Caregnato, Rita Catalina Aquino

    2014-10-01

    To investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC) taxonomy. Retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012). The data of the patients' profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded. The majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6%) were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses. It was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy.

  5. Interventions to prevent back pain and back injury in nurses: a systematic review.

    PubMed

    Dawson, Anna P; McLennan, Skye N; Schiller, Stefan D; Jull, Gwendolen A; Hodges, Paul W; Stewart, Simon

    2007-10-01

    A systematic literature review was undertaken to assess the effectiveness of interventions that aim to prevent back pain and back injury in nurses. Ten relevant databases were searched; these were examined and reference lists checked. Two reviewers applied selection criteria, assessed methodological quality and extracted data from trials. A qualitative synthesis of evidence was undertaken and sensitivity analyses performed. Eight randomised controlled trials and eight non-randomised controlled trials met eligibility criteria. Overall, study quality was poor, with only one trial classified as high quality. There was no strong evidence regarding the efficacy of any interventions aiming to prevent back pain and injury in nurses. The review identified moderate level evidence from multiple trials that manual handling training in isolation is not effective and multidimensional interventions are effective in preventing back pain and injury in nurses. Single trials provided moderate evidence that stress management programs do not prevent back pain and limited evidence that lumbar supports are effective in preventing back injury in nurses. There is conflicting evidence regarding the efficacy of exercise interventions and the provision of manual handling equipment and training. This review highlights the need for high quality randomised controlled studies to examine the effectiveness of interventions to prevent back pain and injury in nursing populations. Implications for future research are discussed.

  6. Interventions to prevent back pain and back injury in nurses: a systematic review

    PubMed Central

    Dawson, Anna P; McLennan, Skye N; Schiller, Stefan D; Jull, Gwendolen A; Hodges, Paul W; Stewart, Simon

    2007-01-01

    A systematic literature review was undertaken to assess the effectiveness of interventions that aim to prevent back pain and back injury in nurses. Ten relevant databases were searched; these were examined and reference lists checked. Two reviewers applied selection criteria, assessed methodological quality and extracted data from trials. A qualitative synthesis of evidence was undertaken and sensitivity analyses performed. Eight randomised controlled trials and eight non‐randomised controlled trials met eligibility criteria. Overall, study quality was poor, with only one trial classified as high quality. There was no strong evidence regarding the efficacy of any interventions aiming to prevent back pain and injury in nurses. The review identified moderate level evidence from multiple trials that manual handling training in isolation is not effective and multidimensional interventions are effective in preventing back pain and injury in nurses. Single trials provided moderate evidence that stress management programs do not prevent back pain and limited evidence that lumbar supports are effective in preventing back injury in nurses. There is conflicting evidence regarding the efficacy of exercise interventions and the provision of manual handling equipment and training. This review highlights the need for high quality randomised controlled studies to examine the effectiveness of interventions to prevent back pain and injury in nursing populations. Implications for future research are discussed. PMID:17522134

  7. Improving timeliness for acute asthma care for paediatric ED patients using a nurse driven intervention: an interrupted time series analysis

    PubMed Central

    Brown, Kathleen; Iqbal, Sabah; Sun, Su-Lin; Fritzeen, Jennifer; Chamberlain, James; C. Mullan, Paul

    2016-01-01

    Asthma is the most common chronic paediatric disease treated in the emergency department (ED). Rapid corticosteroid administration is associated with improved outcomes, but our busy ED setting has made it challenging to achieve this goal. Our primary aim was to decrease the time to corticosteroid administration in a large, academic paediatric ED. We conducted an interrupted time series analysis for moderate to severe asthma exacerbations of one to 18 year old patients. A multidisciplinary team designed the intervention of a bedside nurse initiated administration of oral dexamethasone, to replace the prior system of a physician initiated order for oral prednisone. Our baseline and intervention periods were 12 month intervals. Our primary process measure was the time to corticosteroid administration. Other process measures included ED length of stay, admission rate, and rate of emesis. The balance measures included rate of return visits to the ED or clinic within five days, as well as the proportion of discharged patients who were admitted within five days. No special cause variation occurred in the baseline period. The mean time to corticosteroid administration decreased significantly, from 98 minutes in the baseline period to 59 minutes in the intervention period (p < 0.01), and showed special cause variation improvement within two months after the intervention using statistical process control methodology. We sustained the improvement and demonstrated a stable process. The intervention period had a significantly lower admission rate (p<0.01) and emesis rate (p<0.01), with no unforeseen harm to patients found with any of our balance measures. In summary, the introduction of a nurse initiated, standardized protocol for corticosteroid therapy for asthma exacerbations in a paediatric ED was associated with decreased time to corticosteroid administration, admission rates, and post-corticosteroid emesis. PMID:28090325

  8. Improving timeliness for acute asthma care for paediatric ED patients using a nurse driven intervention: an interrupted time series analysis.

    PubMed

    Brown, Kathleen; Iqbal, Sabah; Sun, Su-Lin; Fritzeen, Jennifer; Chamberlain, James; Mullan, Paul C

    2016-01-01

    Asthma is the most common chronic paediatric disease treated in the emergency department (ED). Rapid corticosteroid administration is associated with improved outcomes, but our busy ED setting has made it challenging to achieve this goal. Our primary aim was to decrease the time to corticosteroid administration in a large, academic paediatric ED. We conducted an interrupted time series analysis for moderate to severe asthma exacerbations of one to 18 year old patients. A multidisciplinary team designed the intervention of a bedside nurse initiated administration of oral dexamethasone, to replace the prior system of a physician initiated order for oral prednisone. Our baseline and intervention periods were 12 month intervals. Our primary process measure was the time to corticosteroid administration. Other process measures included ED length of stay, admission rate, and rate of emesis. The balance measures included rate of return visits to the ED or clinic within five days, as well as the proportion of discharged patients who were admitted within five days. No special cause variation occurred in the baseline period. The mean time to corticosteroid administration decreased significantly, from 98 minutes in the baseline period to 59 minutes in the intervention period (p < 0.01), and showed special cause variation improvement within two months after the intervention using statistical process control methodology. We sustained the improvement and demonstrated a stable process. The intervention period had a significantly lower admission rate (p<0.01) and emesis rate (p<0.01), with no unforeseen harm to patients found with any of our balance measures. In summary, the introduction of a nurse initiated, standardized protocol for corticosteroid therapy for asthma exacerbations in a paediatric ED was associated with decreased time to corticosteroid administration, admission rates, and post-corticosteroid emesis.

  9. The effects of a mobile stress management protocol on nurses working with cancer patients: a preliminary controlled study.

    PubMed

    Villani, Daniela; Grassi, Alessandra; Cognetta, Chiara; Cipresso, Pietro; Toniolo, Davide; Riva, Giuseppe

    2012-01-01

    Oncology nurses face extraordinary stresses that may lead to emotional exhaustion, a feeling of emotional distance from patients and burnout. The presentation describes the preliminary results of a study to test the effects of an innovative 4-week 8-session self-help stress management training for oncology nurses supported by mobile tools (Nokia N70 smarthphone). The sample included 16 female oncology nurses with permanent status employed in different oncology hospitals in Milan, Italy. The study used a between-subjects design, comparing the experimental condition (mobile phone stress management protocol) with a control group (neutral videos through mobile phones). In addition to a significant reduction in anxiety state at the end of each session, the experimental group demonstrated a significant improvement in affective change in terms of anxiety trait reduction and coping skills acquisition at the end of the protocol.

  10. The use of the Nursing Interventions Classification (NIC) with cardiac patients receiving home health care.

    PubMed

    Schneider, Julia Stocker; Slowik, Linda Haynes

    2009-01-01

    To identify Nursing Interventions Classification interventions (NICs) commonly provided to cardiac home care patients and to explore differences among patients with coronary artery disease, congestive heart failure, and patients with other cardiac disorders. The NICs provided to cardiac home care patients were recorded and analyzed to determine differences in frequencies across cardiac diagnoses. Frequent NICs provided in cardiac home care are similar across diagnoses, and include tissue perfusion management and patient education NICs. Variations can be detected and involve fluid monitoring/management, exercise promotion/teaching, and cardiac care NICs. Differences in nursing care among patients with similar medical diagnoses can be detected using NIC. Relevant knowledge of nursing care can be gleaned from analyzing NIC data generated in practice and can be used to plan, evaluate, and determine the effectiveness of nursing care.

  11. Design of a nurse-run, telephone-based intervention to improve lipids in diabetics.

    PubMed

    Fischer, Henry; Mackenzie, Thomas; McCullen, Kevin; Everhart, Rachel; Estacio, Raymond O

    2008-09-01

    This randomized, controlled trial tested the effectiveness of a nurse-run, telephone-based intervention to improve lipid control in patients with diabetes. Our patient population is predominantly low-income and Latino. Using our diabetes registry, we randomly assigned 381 patients to continue with their usual care and 381 to participate in our nurse-run program. Three registered nurses learned algorithms for diabetes care. These algorithms address management of lipids, glycemic control, blood pressure, nephropathy, aspirin use, eye screening, pneumovax and influenza vaccines, obesity, and cigarette smoking. The nurses were also trained in motivational interviewing techniques and facilitation of patient self-management. The primary goal was to improve lipid control in our diabetic population. Secondary outcomes address blood pressure control, glycemic control, renal function, and medication adherence. In addition, a cost-effective analysis is being performed. This article summarizes the design of the intervention.

  12. Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity.

    PubMed

    Mann, Courtney M; Ward, Dianne S; Vaughn, Amber; Benjamin Neelon, Sara E; Long Vidal, Lenita J; Omar, Sakinah; Namenek Brouwer, Rebecca J; Østbye, Truls

    2015-12-10

    Many families rely on child care outside the home, making these settings important influences on child development. Nearly 1.5 million children in the U.S. spend time in family child care homes (FCCHs), where providers care for children in their own residences. There is some evidence that children in FCCHs are heavier than those cared for in centers. However, few interventions have targeted FCCHs for obesity prevention. This paper will describe the application of the Intervention Mapping (IM) framework to the development of a childhood obesity prevention intervention for FCCHs Following the IM protocol, six steps were completed in the planning and development of an intervention targeting FCCHs: needs assessment, formulation of change objectives matrices, selection of theory-based methods and strategies, creation of intervention components and materials, adoption and implementation planning, and evaluation planning Application of the IM process resulted in the creation of the Keys to Healthy Family Child Care Homes program (Keys), which includes three modules: Healthy You, Healthy Home, and Healthy Business. Delivery of each module includes a workshop, educational binder and tool-kit resources, and four coaching contacts. Social Cognitive Theory and Self-Determination Theory helped guide development of change objective matrices, selection of behavior change strategies, and identification of outcome measures. The Keys program is currently being evaluated through a cluster-randomized controlled trial The IM process, while time-consuming, enabled rigorous and systematic development of intervention components that are directly tied to behavior change theory and may increase the potential for behavior change within the FCCHs.

  13. Using the Intervention Mapping Protocol to develop an online video intervention for parents to prevent childhood obesity: Movie Models.

    PubMed

    De Lepeleere, Sara; Verloigne, Maïté; Brown, Helen Elizabeth; Cardon, Greet; De Bourdeaudhuij, Ilse

    2016-08-08

    The increasing prevalence of childhood overweight/obesity caused by an unhealthy diet, insufficient physical activity (PA) and high levels of sedentary behaviour (SB) is a prominent public health concern. Parenting practices may contribute to healthy behaviour change in children, but well-researched examples are limited. The aim of this study is to describe the systematic development of an intervention for parents to prevent childhood overweight/obesity through the improvement of parenting practices. The six steps of the Intervention Mapping Protocol (IMP), a theory- and evidence-based tool to develop health-related interventions, were used as a framework to develop the 'Movie Models' programme. In Step 1, a needs assessment was performed to better understand the health problem of overweight/obesity in children and its association with diet, PA and SB. In Step 2, the programme goal (increasing the adoption of effective parenting practices) was sub-divided into performance objectives. Change objectives, which specify explicit actions required to accomplish the performance objectives, were also identified. Step 3 included the selection of theoretical methods (e.g. 'modelling' and 'images'), which were then translated into the practical strategy of online parenting videos. Step 4 comprised the development of a final intervention framework, and Step 5 included the planning of programme adoption and implementation. The final phase, Step 6, included the development of an effect- and process-evaluation plan. The IMP was used to structure the development of 'Movie Models', an intervention targeting specific parenting practices related to children's healthy diet, PA, SB, and parental self-efficacy. A clear framework for process analyses is offered, which aims to increase the potential effectiveness of an intervention and can be useful for those developing health promotion programmes. © The Author(s) 2016.

  14. Optimisation of imaging protocols in interventional cardiology: impact on patient doses.

    PubMed

    Ordiales, J M; Vano, E; Nogales, J M; Ramos, J; López-Mínguez, J R; Martínez, G; Cerrato, P; Álvarez, F J

    2017-09-01

    The purpose of this work is to evaluate the impact of the imaging protocol as part of the optimisation of patient doses in interventional cardiology. This paper reports the results of an initial study to refine the existing fluoroscopy and cine settings, evaluates a new imaging protocol by measuring the image quality and phantom entrance air kerma values, and tests the clinical implementation of the new protocol in terms of the reduction in patient doses and the impact on clinical images. The initial study developed a new fluoroscopy mode using 7.5 frames s(-1) (instead of the previous 15 frames s(-1)) with a similar dose/frame and a reduction of approximately 26% in dose/frame for the existing standard cine mode. For the new imaging protocol, the reduction in entrance air kerma was characterised for water depths of 16, 20, and 24 cm and the image quality was evaluated using a Leeds test object. A reduction in dose of around 50% was observed for the low fluoroscopy mode and an 18%-38% reduction was measured for cine. The image quality was unchanged in fluoroscopy mode and did not suffer noticeable alterations in cine mode. In the clinical implementation, cardiologists evaluated the new imaging protocol in clinical practice and cooperated with medical physicists to ensure full optimisation. The image quality criteria evaluated the ability to visualise the standard coronary arteries and small vessels (<2 mm), and the proper visualisation of the heart and diaphragm. A total of 1635 interventional cardiac procedures were assessed. The median kerma-area product exhibited a reduction of 37% for CA and 43% for PTCA examinations, and the quality of the clinical images was considered sufficient for standard clinical practice.

  15. Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention.

    PubMed

    Verbestel, Vera; De Henauw, Stefaan; Maes, Lea; Haerens, Leen; Mårild, Staffan; Eiben, Gabriele; Lissner, Lauren; Moreno, Luis A; Frauca, Natalia Lascorz; Barba, Gianvincenzo; Kovács, Eva; Konstabel, Kenn; Tornaritis, Michael; Gallois, Katharina; Hassel, Holger; De Bourdeaudhuij, Ilse

    2011-08-01

    The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The

  16. Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention

    PubMed Central

    2011-01-01

    Background The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. Methods The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. Results The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. Conclusions The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to

  17. Nursing stress and patient care: real-time investigation of the effect of nursing tasks and demands on psychological stress, physiological stress, and job performance: study protocol.

    PubMed

    Farquharson, Barbara; Bell, Cheryl; Johnston, Derek; Jones, Martyn; Schofield, Pat; Allan, Julia; Ricketts, Ian; Morrison, Kenny; Johnston, Marie

    2013-10-01

    To examine the effects of nursing tasks (including their physiological and psychological demands, and the moderating effects of reward and control) on distress and job performance in real time. Nurses working in hospital settings report high levels of occupational stress. Stress in nurses has been linked to reduced physical and psychological health, reduced job satisfaction, increased sickness absence, increased staff turnover, and poorer job performance. In this study, we will investigate theoretical models of stress and use multiple methods, including real-time data collection, to assess the relationship between stress and different nursing tasks in general medical and surgical ward nurses. A real-time, repeated measures design. During 2011/2012, 100 nurses from a large general teaching hospital in Scotland will: (a) complete self-reports of mood; (b) have their heart rate and activity monitored over two shifts to obtain physiological indices of stress and energy expenditure; (c) provide perceptions of the determinants of stress in complex ward environments; and (d) describe their main activities. All measures will be taken repeatedly in real time over two working shifts. Data obtained in this study will be analysed to examine the relationships between nursing tasks, self-reported and physiological measures of stress and to assess the effect of occupational stress on multiple work outcomes. The results will inform theoretical understanding of nurse stress and its determinants and suggest possible targets for intervention to reduce stress and associated harmful consequences. © 2013 Blackwell Publishing Ltd.

  18. Nursing peer review of late deceleration recognition and intervention to improve patient safety.

    PubMed

    Davis, Jocelyn; Kenny, Tiffany H; Doyle, Jennifer L; McCarroll, Michele; von Gruenigen, Vivian E

    2013-01-01

    We describe a nurse peer-review process to improve late deceleration recognition and intervention on one labor and delivery unit. Monthly chart audits (n = 721) met the goal of 75% reviewer agreement after the 4th month of implementation and have been maintained to date. Nurses recognized for excellence were more likely to be certified, work day shift, or be a member of the Perinatal Safety Team. Institutional support, a dedicated review team, and education contributed to success.

  19. Model testing on the crisis interventions and actions to prevent medical disputes: a Taiwanese nursing perspective.

    PubMed

    Tzeng, Huey-Ming

    2006-05-01

    This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system. In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis. In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study. The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities. These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening

  20. Perceived learning needs according to patients who have undergone major coronary interventions and their nurses.

    PubMed

    Mosleh, Sultan M; Eshah, Nidal F; Almalik, Mona Ma

    2017-02-01

    The aim of this study was to identify the differences in perceived learning needs between cardiac patients who have undergone major coronary interventions and their nurses. The decrease in length of stay after cardiac interventions has signalled an urgent need to provide effective in-hospital health education. Therefore, the content of health education should bridge the gap between nurses' and patients' views of what information is important for ensuring patients' optimum recovery. A descriptive comparative design was employed. Patients were invited to participate if they had undergone angioplasty or bypass surgery and were ready for discharge within 24-48 hours. A convenience sample of 365 cardiac patients and 166 cardiac nurses participated in this study. Baseline data on patients' and nurses' sociodemographics, clinical history and experience were collected through personal interviews. Then, participants completed the Patient Learning Needs Scale to identify their perceptions of the learning needs after cardiac interventions. The top-priority learning needs according to both patients and cardiac nurses was information on wound care and medication. In contrast, the lowest-priority learning need was physical activity. Nurses perceived information about physical activity as most needed to patients, whereas patients perceived information about medications, postintervention complications and postintervention concerns as mostly needed. The disparity between perceptions of patient and nurses on the essential content to be learned highlights the importance of considering both of these parties when establishing health education programmes. In addition, nurses should focus more on information related to the recovery period and immediate needs after discharge. Information about wound care, medication and potential complications should be the core of predischarge education programmes. In addition, nurses should focus on improve patients' awareness of secondary prevention

  1. [Analysis of publications on Nursing Interventions Classification (NIC) from 1980 to 2004].

    PubMed

    Napoleão, Anamaria Alves; Chianca, Tânia Couto Machado; de Carvalho, Emília Campos; Dalri, Maria Célia Barcellos

    2006-01-01

    This study aimed at reviewing the knowledge produced about the Nursing Interventions Classification (NIC) available in the scientific literature from January 1980 to January 2004. NIC is a taxonomy with activities performed by nurses. Authors searched Lilacs and Medline databases, materials at the Center for Nursing Classification-University of Iowa College of Nursing and a doctoral dissertation obtained from a private library. The works found referred to the application of NIC to practice, the languages used in information systems, the use of NIC in these systems and the presentation, construction, development and validation of a taxonomy, among others. Authors concluded that there are several possibilities related to the production of knowledge on NIC in Brazil and that it is necessary to encourage studies on this taxonomy, raising questions and generating new knowledge to contribute to the improvement of Brazilian Nursing.

  2. Effectiveness of an education program to prevent nurses' low back pain: an interventional study in Turkey.

    PubMed

    Karahan, Azize; Bayraktar, Nurhan

    2013-02-01

    This study was undertaken to evaluate an education program to prevent low back pain among nurses. This interventional study used a one-group, pretest/posttest design and was conducted in four hospitals in Bolu, Turkey. Nurses' knowledge was assessed before and after training; 60 nurses were evaluated while performing five procedures that can lead to low back pain using an observation form. These forms were given to the nurses 3 months after the training to assess their knowledge and observations of the five specified behaviors were repeated. The mean knowledge and procedures scores of the nurses were higher just after and 3 months after the training compared to before training. Copyright 2013, SLACK Incorporated.

  3. Rapid intervention and treatment zone: redesigning nursing services to meet increasing emergency department demand.

    PubMed

    Considine, Julie; Lucas, Elspeth; Martin, Roslyn; Stergiou, Helen E; Kropman, Matthew; Chiu, Herman

    2012-02-01

    The impact of emergency nursing roles in demand management systems is poorly understood. The aim of this study was to evaluate emergency nurses' role in a specific emergency department (ED) demand management system: rapid intervention and treatment zone (RITZ). A descriptive exploratory approach was used. Data were collected from audit of 193 randomly selected patient records and 12 h of clinical practice observation. The median age of participants was 31 years, 51.8% were males and 99.5% were discharged home. Nurse qualifications or seniority had no significant effect on waiting time or length of stay (LOS). There were disparities between documented and observed nursing practice. The designation and qualifications of RITZ nurses made little difference to waiting times and ED LOS. Specific documentation and communication systems for areas of the ED that manage large numbers of low complexity patients warrant further research.

  4. The Patient Remote Intervention and Symptom Management System (PRISMS) - a Telehealth- mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies: study protocol for a randomised controlled trial.

    PubMed

    Breen, Sibilah; Ritchie, David; Schofield, Penelope; Hsueh, Ya-Seng; Gough, Karla; Santamaria, Nick; Kamateros, Rose; Maguire, Roma; Kearney, Nora; Aranda, Sanchia

    2015-10-19

    Outpatient chemotherapy is a core treatment for haematological malignancies; however, its toxicities frequently lead to distressing/potentially life-threatening side-effects (neutropenia/infection, nausea/vomiting, mucositis, constipation/diarrhoea, fatigue). Early detection/management of side-effects is vital to improve patient outcomes, decrease morbidity and limit lengthy/costly hospital admissions. The ability to capture patient-reported health data in real-time, is regarded as the 'gold-standard' to allow rapid clinical decision-making/intervention. This paper presents the protocol for a Phase 3 multi-site randomised controlled trial evaluating a novel nurse-led Telehealth intervention for remote monitoring/management of chemotherapy side-effects in Australian haematological cancer patients. Two hundred and twenty-two patients will be recruited from two hospitals. Eligibility criteria include: diagnosis of chronic lymphocytic leukaemia/Hodgkin's/non-Hodgkin's lymphoma; aged ≥ 18 years; receiving ≥ 2 cycles chemotherapy. Patients will be randomised 1:1 to either the control or intervention arm with stratification by diagnosis, chemotherapy toxicity (high versus low), receipt of previous chemotherapy and hospital. Patients allocated to the control arm will receive 'Usual Care' whilst those allocated to the intervention will receive the intervention in addition to 'Usual Care'. Intervention patients will be provided with a computer tablet and software prompting twice-daily completion of physical/emotional scales for up to four chemotherapy cycles. Should patient data exceed pre-determined limits an Email alert is delivered to the treatment team, prompting nurses to view patient data, and contact the patient to provide clinical intervention. In addition, six scheduled nursing interventions will be completed to educate/support patients in use of the software. Patient outcomes will be measured cyclically (midpoint and end of cycles) via pen

  5. Interventions for supporting nurse retention in rural and remote areas: an umbrella review

    PubMed Central

    2013-01-01

    Context Retention of nursing staff is a growing concern in many countries, especially in rural, remote or isolated regions, where it has major consequences on the accessibility of health services. Purpose This umbrella review aims to synthesize the current evidence on the effectiveness of interventions to promote nurse retention in rural or remote areas, and to present a taxonomy of potential strategies to improve nurse retention in those regions. Methods We conducted an overview of systematic reviews, including the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. We used the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) criteria in order to assess the quality of the reports. Findings Of 517 screened publications, we included five reviews. Two reviews showed that financial-incentive programs have substantial evidence to improve the distribution of human resources for health. The other three reviews highlighted supportive relationships in nursing, information and communication technologies support and rural health career pathways as factors influencing nurse retention in rural and remote areas. Overall, the quality of the reviews was acceptable. Conclusions This overview provides a guide to orient future rural and remote nurse retention interventions. We distinguish four broad types of interventions: education and continuous professional development interventions, regulatory interventions, financial incentives, and personal and professional support. More knowledge is needed regarding the effectiveness of specific strategies to address the factors known to contribute to nurse retention in rural and remote areas. In order to ensure knowledge translation, retention strategies should be rigorously evaluated using appropriate designs. PMID:24025429

  6. Protocol adherence for continuously titrated interventions in randomized trials: an overview of the current methodology and case study.

    PubMed

    Lauzier, F; Adhikari, N K; Seely, A; Koo, K K Y; Belley-Côté, E P; Burns, K E A; Cook, D J; D'Aragon, F; Rochwerg, B; Kho, M E; Oczkowksi, S J W; Duan, E H; Meade, M O; Day, A G; Lamontagne, F

    2017-07-17

    The standard definition for protocol adherence is the proportion of all scheduled doses that are delivered. In clinical research, this definition has several limitations when evaluating protocol adherence in trials that study interventions requiring continuous titration. Building upon a specific case study, we analyzed a recent trial of a continuously titrated intervention to assess the impact of different definitions of protocol deviations on the interpretation of protocol adherence. The OVATION pilot trial was an open-label randomized controlled trial of higher (75-80 mmHg) versus lower (60-65 mmHg) mean arterial pressure (MAP) targets for vasopressor therapy in shock. In this trial, potential protocol deviations were defined as MAP values outside the targeted range for >4 consecutive hours during vasopressor therapy without synchronous and consistent adjustments of vasopressor doses. An adjudication committee reviewed each potential deviation to determine if it was clinically-justified or not. There are four reasons for this contextual measurement and reporting of protocol adherence. First, between-arm separation is a robust measure of adherence to complex protocols. Second, adherence assessed by protocol deviations varies in function of the definition of deviations and the frequency of measurements. Third, distinguishing clinically-justified vs. not clinically-justified protocol deviations acknowledges clinically sensible bedside decision-making and offers a clear terminology before the trial begins. Finally, multiple metrics exist to report protocol deviations, which provides different information but complementary information on protocol adherence. In trials of interventions requiring continuous titration, metrics used for defining protocol deviations have a considerable impact on the interpretation of protocol adherence. Definitions for protocol deviations should be prespecified and correlated with between-arm separation, if it can be measured.

  7. Nurses' Experience of Using an Application to Support New Parents after Early Discharge: An Intervention Study

    PubMed Central

    Rønde Kristensen, Bjarne; Clemensen, Jane

    2015-01-01

    Background. A development towards earlier postnatal discharge presents a challenge to find new ways to provide information and support to families. A possibility is the use of telemedicine. Objective. To explore how using an app in nursing practice affects the nurses' ability to offer support and information to postnatal mothers who are discharged early and their families. Design. Participatory design. An app with a chat, a knowledgebase, and automated messages was tried out between hospital and parents at home. Settings. The intervention took place on a postnatal ward with approximately 1,000 births a year. Participants. At the onset of the intervention, 17 nurses, all women, were working on the ward. At the end of the intervention, 16 nurses were employed, all women. Methods. Participant observation and two focus group interviews. The data analysis was inspired by systematic text condensation. Results. The nurses on the postnatal ward consider that the use of the app gives families easier access to timely information and support. Conclusions. The app gives the nurses the possibility to offer support and information to the parents being early discharged. The app is experienced as a lifeline that connects the homes of the new parents with the hospital. PMID:25699079

  8. [Accuracy of nursing interventions for patients with type 2 diabetes mellitus in outpatient consultation].

    PubMed

    Scain, Suzana Fiore; Franzen, Elenara; dos Santos, Luciana Batista; Heldt, Elizeth

    2013-06-01

    The objective of this study was to identify the accuracy of nursing interventions from the nursing diagnoses (ND) of patients who consulted in the Program for Diabetes Education, in outpatient care of the university hospital relating them with sociodemographic characteristics and comorbidities. It was a cross-sectional study of 136 patients with type 2 diabetes mellitus (DM2), with 77 (57%) women, with an average age of 66 +/- 9.38 years, and the presence of comorbidities in 97 (71%), and using medications. A significant association was found between the NDs and the most frequently prescribed interventions. "nutritional counseling" (n=99; 73%), "promotion of exercise" (n=64; 47%) and "teaching: feet care (n=48; 35%); however, not with the sociodemographic characteristics or comorbidities. The interventions most prescribed in nursing consultations showed ND accuracy for the domains of Promotion of Health and Nutrition, which are related to the principles of treatment for DM2: healthy eating, physical exercise and health education.

  9. Teaching Handoff Communication to Nursing Students: A Teaching Intervention and Lessons Learned.

    PubMed

    Lee, Jamie; Mast, Merle; Humbert, Janelle; Bagnardi, Margaret; Richards, Sharlene

    2016-01-01

    When new-graduate nurses enter practice, they are expected to provide clear, effective handoff reports during care transitions. However, few nursing programs offer systematic instruction or opportunities to practice this important form of communication. This article describes a teaching intervention designed to prepare students with handoff skills they will need in practice. Data gathered to evaluate its effectiveness indicated that skill repetition improved student performance and perceived self-efficacy of handoff reporting. Lessons learned and recommendations for incorporating this instruction into nursing curricula are discussed.

  10. Sedation scoring and managing abilities of intensive care nurses post educational intervention.

    PubMed

    Ramoo, Vimala; Abdullah, Khatijah Lim; Tan, Patrick Sk; Wong, Li Ping; Chua, Yan Piaw; Tang, Li Yoong

    2017-05-01

    Inappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients. This study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes. A post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention. A total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention. Median scores for overall accurate sedation scoring (9 months: 4·00; 3 months: 2·00, p = 0·0001) and overall sedation management (9 months: 14·0; 3 months: 7·0, p = 0·0001) were significantly higher at 9 months compared to 3 months post-intervention. There were no significant differences in the perceived self-confidence level for rating sedation level. Overall perceived barrier scores were low (M = 27·78, SD = 6·26, possible range = 11·0-55·0). Patient conditions (M = 3·68, SD = 1·13) and nurses' workload (M = 3·54, SD = 0·95) were the greatest barriers to effective sedation assessment and management. Demographic variables did not affect sedation scoring or management abilities. Positive changes in nurses' sedation assessment and management abilities were observed, indicating that adequate hands

  11. Bank robberies: A psychological protocol of intervention in financial institutions and principal effects.

    PubMed

    Tabanelli, Maria Carla; Bonfiglioli, Roberta; Violante, Francesco S

    2013-03-26

    BACKGROUND: Robbery in workplaces represents a potentially traumatic experience for workers. OBJECTIVES: This article describes the set up and evaluation of a comprehensive psychological intervention designed to help to reduce the adverse consequences of bank robberies. PARTICIPANTS: The study population was selected among the employees of two Italian banks.METHODS: The psychological protocol was designed according to the results of a comprehensive non-systematic review of the scientific literature and it was evaluated at work site. RESULTS: The protocol consists of a "pre-event" formative intervention and "post-event" psychological support. The qualitative data collected allowed us to understand that the reactions after a robbery can differ depending on the phase during which the workers were exposed to the robbery. We noted that the main consequences can be classified in emotional/sentimental reactions, behavioral reactions, physiological reactions and experiences during the event; emotions/feelings following the robbery and psycho/physical state and emotions/feelings in the following days.CONCLUSIONS: In a working environment, the chance to take advantage of a specific protocol for the traumatic event of a bank robbery offers both the company and the workers important tools for well-being, including post-robbery psychological support and classroom instructions.

  12. An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety.

    PubMed

    He, Liping; Lu, Zhiyan; Huang, Jing; Zhou, Yiping; Huang, Jian; Bi, Yongyi; Li, Jun

    2016-11-07

    Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses' knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ² = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ² = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre

  13. [Intervention of mobile palliative care team on nursing homes: retrospective study].

    PubMed

    Piot, Elise; Leheup, Benoît F; Losson, Séverine; Gédor, Lorène; Domina, Lucie; Béhem, Chantal; Amanzouggarene, Malika

    2014-12-01

    Interventions of mobile palliative care teams in nursing homes have been the subject special consideration, however very little data are available on this subject. To determine the proportion of patients followed and consultations conducted in nursing homes for the dependent elderly by a mobile palliative care team, to describe the patients followed and to analyze the various aspects of this intervention. Retrospective study on the interventions carried out by a mobile palliative care team in nursing homes between January 1st and December 31st, 2012. The interventions in nursing homes targeted, 7.2% of the followed patients and represented 8.7% of the total activity of the mobile team. Intervention requests were made primarily by the family physician. The followed patients were mostly women (63%), with a mean age of 84 years, presenting non-cancerous diseases (78.2%), and had an average of 4.4 consultations. Half of the patients died during follow-up. Three quarters of the patients presented pain, neuro-psychological symptoms and verbal communication disorders. Four out of ten patients met with the occupational therapist and one of ten, the psychologist. The activity of mobile palliative care teams remains marginal, although steadily (on the rise. The collected data illustrate the specificity of geriatric palliative care, while certain characteristics inherent to nursing homes require establishing appropriate therapy proposals. Although quantitatively limited, the activity of mobile palliative care teams in nursing homes appears important as these interventions are likely meet the needs of both patients and staff in addition to enabling patients in palliative care to remain at their current place of residence.

  14. Educational interventions to empower nursing home residents: a systematic literature review.

    PubMed

    Schoberer, Daniela; Leino-Kilpi, Helena; Breimaier, Helga E; Halfens, Ruud Jg; Lohrmann, Christa

    2016-01-01

    Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents. A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents. An additional, manual search of the reference lists and searches with SIGLE and Google Scholar were conducted to identify gray literature. Two authors independently appraised the quality of the studies found and assigned levels to the evidence reported. The results of the studies were grouped according to their main empowering outcomes and described narratively. Out of 427 identified articles, ten intervention studies that addressed the research question were identified. The main educational interventions used were group education sessions, motivational and encouragement strategies, goal setting with residents, and the development of plans to meet defined goals. Significant effects on self-efficacy and self-care behavior were reported as a result of the interventions, which included group education and individual counseling based on resident needs and preferences. In addition, self-care behavior was observed to significantly increase in response to function-focused care and reasoning exercises. Perceptions and expectations were not improved by using educational interventions with older nursing home residents. Individually tailored, interactive, continuously applied, and structured educational strategies, including motivational and encouraging techniques, are promising interventions that can help nursing home residents become more empowered. Empowering strategies used by nurses can

  15. A Multidisciplinary Workplace Intervention for Chronic Low Back Pain among Nursing Assistants in Iran.

    PubMed

    Shojaei, Sarallah; Tavafian, Sedigheh Sadat; Jamshidi, Ahmad Reza; Wagner, Joan

    2017-06-01

    Interventional research with a 6-month follow-up period. We aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory. WRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP. We included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data. The comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group (p<0.001) and no significant change in control groups. There was no significant difference in the disability scores between the two groups (p=0.07). We showed that our multidisciplinary intervention could reduce the intensity of WRLBP among nurse aides, making them suitable for implementation in programs to improve WRLBP among nursing assistants working in hospitals.

  16. Educational interventions to empower nursing home residents: a systematic literature review

    PubMed Central

    Schoberer, Daniela; Leino-Kilpi, Helena; Breimaier, Helga E; Halfens, Ruud JG; Lohrmann, Christa

    2016-01-01

    Purpose of the study Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents. Methods A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents. An additional, manual search of the reference lists and searches with SIGLE and Google Scholar were conducted to identify gray literature. Two authors independently appraised the quality of the studies found and assigned levels to the evidence reported. The results of the studies were grouped according to their main empowering outcomes and described narratively. Results Out of 427 identified articles, ten intervention studies that addressed the research question were identified. The main educational interventions used were group education sessions, motivational and encouragement strategies, goal setting with residents, and the development of plans to meet defined goals. Significant effects on self-efficacy and self-care behavior were reported as a result of the interventions, which included group education and individual counseling based on resident needs and preferences. In addition, self-care behavior was observed to significantly increase in response to function-focused care and reasoning exercises. Perceptions and expectations were not improved by using educational interventions with older nursing home residents. Conclusion Individually tailored, interactive, continuously applied, and structured educational strategies, including motivational and encouraging techniques, are promising interventions that can help nursing home residents become more

  17. Educational intervention to decrease stigmatizing attitudes of undergraduate nurses towards people with mental illness.

    PubMed

    Bingham, Helen; O'Brien, Anthony John

    2017-03-07

    Health professionals can hold stigmatizing views about people with mental illness. In addition to being discriminatory, these beliefs cause anxiety that can affect learning in the clinical environment. A review of an undergraduate nursing curriculum introduced the Modern Apprenticeship curriculum model and provided an opportunity for an educational intervention designed to address stigmatizing beliefs about people with mental health and addiction problems. The aim of the present study was to measure the extent to which an educational intervention - guided clinical experience in an acute mental health unit during the first year of the curriculum - decreased stigmatizing beliefs of undergraduate nurses towards those with mental health and addiction issues. In a before-and-after design, Corrigan's Attribution Questionnaire was used to collect data pre- and post-guided clinical experience in an acute mental health unit. The intervention resulted in a significant positive change in stigmatizing attitudes for four of the nine factors tested. There was a non-significant positive change in three factors, while two factors showed a non-significant negative change. Using guided clinical experience as an educational intervention in the first year of an undergraduate nursing curriculum can contribute to positive change in undergraduate nurses' stigmatizing beliefs. The findings have implications for teaching of mental health content in undergraduate nursing programmes.

  18. An eHealth education intervention to promote healthy lifestyles among nurses.

    PubMed

    Tsai, Yueh-Chi; Liu, Chieh-Hsing

    2015-01-01

    Nurses often do not adhere to health-promoting lifestyles, compromising their health status and quality of care. This study aimed to evaluate health-promoting effects of an eHealth intervention among nurses compared with conventional handbook learning. This controlled before/after study enrolled 105 nurses, 55 in an experimental group and 60 in a control group, for 3 months of intervention. Both groups completed pre- and postintervention questionnaires of the Health-Promoting Lifestyle Profile and Short-Form Health Survey. Subjects' height, weight, and body mass index were recorded. The eHealth education intervention had the effect of significantly increasing nurses' postintervention Health-Promoting Lifestyle Profile total scores. No significant changes were observed in the postintervention scores of the control group subjects. The experimental group also had significant postintervention decreases in BMI, but no similar changes were observed in the control group. Tailored eHealth education is an effective and accessible intervention for enhancing health-promoting behavior among nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study.

    PubMed

    De Craemer, M; De Decker, E; De Bourdeaudhuij, I; Verloigne, M; Duvinage, K; Koletzko, B; Ibrügger, S; Kreichauf, S; Grammatikaki, E; Moreno, L; Iotova, V; Socha, P; Szott, K; Manios, Y; Cardon, G

    2014-08-01

    Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers. © 2014 World Obesity.

  20. An evaluation of orthopaedic nurses' participation in an educational intervention promoting research usage--a triangulation convergence model.

    PubMed

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

    2016-03-01

    To describe the orthopaedic nurses' experiences regarding the relevance of an educational intervention and their personal and contextual barriers to participation in the intervention. One of the largest barriers against nurses' research usage in clinical practice is the lack of participation. A previous survey identified 32 orthopaedic nurses as interested in participating in nursing research. An educational intervention was conducted to increase the orthopaedic nurses' research knowledge and competencies. However, only an average of six nurses participated. A triangulation convergence model was applied through a mixed methods design to combine quantitative results and qualitative findings for evaluation. Data were collected from 2013-2014 from 32 orthopaedic nurses in a Danish regional hospital through a newly developed 21-item questionnaire and two focus group sessions. Data were first analysed using descriptive statistics (stata 12.0) and qualitative manifest content analysis. Second, the results were compared, contrasted and interpreted using international literature. The nurses experienced the intervention as a new way to focus on nursing research in practice. However, some nurses were not able to see the relevance of research usage in clinical practice. Nursing research was not a top priority for the nurses and their personal barriers for research usage during their working day were prioritising patients' and colleagues' well-being. Their colleagues' and head section nurses' lack of acceptance regarding participation in the teaching session was a contextual barrier for the nurses. The nurses were interested in participating in the intervention. However, some felt restricted by the research-practice gap and by diverse personal and contextual barriers. The knowledge derived from this study has high clinical and practical relevance and is currently used to facilitate the nurses' research usage in the orthopaedic department setting, by working around the

  1. Stress-management program: intervention in nursing student performance anxiety.

    PubMed

    Godbey, K L; Courage, M M

    1994-06-01

    This study measured the effect of an individualized stress-management program on nursing students who identified anxiety as interfering with academic performance in the nursing program. The quasi-experimental longitudinal study used a pretest, posttest, and follow-up test, control group design. Data were analyzed using t tests and analysis of variance (ANOVAS). In a 6-week counseling program students identified personal stress reactions and adapted coping strategies related to nutrition, exercise, progressive relaxation, cognitive control, time management, and testing skills to personal use. The program was effective in significantly increasing self-esteem and decreasing depression and anxiety. Grades improved sufficiently for student retention.

  2. Expanded roles and responsibilities for nurses in screening, brief intervention, and referral to treatment (SBIRT) for alcohol use.

    PubMed

    Strobbe, Stephen; Perhats, Cydne; Broyles, Lauren M

    2013-01-01

    It is the position of the International Nurses Society on Addictions and the Emergency Nurses Association that nurses in all practice settings be prepared to deliver screening, brief intervention, and referral to treatment, or SBIRT, to identify and effectively respond to alcohol use and related disorders across the lifespan.

  3. Role of context in care transition interventions for medically complex older adults: a realist synthesis protocol.

    PubMed

    Pitzul, Kristen B; Lane, Natasha E; Voruganti, Teja; Khan, Anum I; Innis, Jennifer; Wodchis, Walter P; Baker, G Ross

    2015-11-19

    Approximately 30-50% of older adults have two or more conditions and are referred to as multimorbid or complex patients. These patients often require visits to various healthcare providers in a number of settings and are therefore susceptible to fragmented healthcare delivery while transitioning to receive care. Care transition interventions have been implemented to improve continuity of care, however, current evidence suggests that some interventions or components of interventions are only effective within certain contexts. There is therefore a need to unpack the mechanisms of how and within which contexts care transition interventions and their components are effective. Realist review is a synthesis method that explains how complex programmes work within various contexts. The purpose of this study is to explain the effect of context on the activities and mechanisms of care transition interventions in medically complex older adults using a realist review approach. This synthesis will be guided by Pawson and colleagues' 2004 and 2005 protocols for conducting realist reviews. The underlying theories of care transition interventions were determined based on an initial literature search using relevant databases. English language peer-reviewed studies published after 1993 will be included. Several relevant databases will be searched using medical subject headings and text terms. A screening form will be piloted and titles, abstracts and full text of potentially relevant articles will be screened in duplicate. Abstracted data will include study characteristics, intervention type, contextual factors, intervention activities and underlying mechanisms. Patterns in Context-Activity-Mechanism-Outcome (CAMO) configurations will be reported. Internal knowledge translation activities will occur throughout the review and existing partnerships will be leveraged to disseminate findings to frontline staff, hospital administrators and policymakers. Finalised results will be

  4. A Guide to Writing a Qualitative Systematic Review Protocol to Enhance Evidence-Based Practice in Nursing and Health Care.

    PubMed

    Butler, Ashleigh; Hall, Helen; Copnell, Beverley

    2016-06-01

    The qualitative systematic review is a rapidly developing area of nursing research. In order to present trustworthy, high-quality recommendations, such reviews should be based on a review protocol to minimize bias and enhance transparency and reproducibility. Although there are a number of resources available to guide researchers in developing a quantitative review protocol, very few resources exist for qualitative reviews. To guide researchers through the process of developing a qualitative systematic review protocol, using an example review question. The key elements required in a systematic review protocol are discussed, with a focus on application to qualitative reviews: Development of a research question; formulation of key search terms and strategies; designing a multistage review process; critical appraisal of qualitative literature; development of data extraction techniques; and data synthesis. The paper highlights important considerations during the protocol development process, and uses a previously developed review question as a working example. This paper will assist novice researchers in developing a qualitative systematic review protocol. By providing a worked example of a protocol, the paper encourages the development of review protocols, enhancing the trustworthiness and value of the completed qualitative systematic review findings. Qualitative systematic reviews should be based on well planned, peer reviewed protocols to enhance the trustworthiness of results and thus their usefulness in clinical practice. Protocols should outline, in detail, the processes which will be used to undertake the review, including key search terms, inclusion and exclusion criteria, and the methods used for critical appraisal, data extraction and data analysis to facilitate transparency of the review process. Additionally, journals should encourage and support the publication of review protocols, and should require reference to a protocol prior to publication of the

  5. A pilot experience launching a national dose protocol for vascular and interventional radiology.

    PubMed

    Vano, E; Segarra, A; Fernandez, J M; Ordiales, J M; Simon, R; Gallego, J J; del Cerro, J; Casasola, E; Verdu, J F; Ballester, T; Sotil, J; Aspiazu, A; Garcia, M A; Moreno, F; Carreras, F; Canis, M; Soler, M M; Palmero, J; Ciudad, J; Diaz, F; Hernandez, J; Gonzalez, M; Rosales, P

    2008-01-01

    The design of a national dose protocol for interventional radiology has been one of the tasks during the European SENTINEL Coordination Action. The present paper describes the pilot experience carried out in cooperation with the Spanish Society on Vascular and Interventional Radiology (SERVEI). A prospective sample of procedures was initially agreed. A common quality control of the X-ray systems was carried out, including calibration of the air kerma area product (KAP) meters. Occupational doses of the radiologists involved in the survey were also included in the survey. A total of 10 Spanish hospitals with interventional X-ray units were involved. Six hundred and sixty-four patient dose data were collected from 397 diagnostic and 267 therapeutic procedures. Occupational doses were evaluated in a sample of 635 values. The obtained KAP median/mean values (Gy.cm2) for the gathered procedures were: biliary drainage (30.6/68.9), fistulography (4.5/9.8), lower limb arteriography (52.2/60.7), hepatic chemoembolisation (175.8/218.3), iliac stent (45.9/73.2) and renal arteriography (39.1/59.8). Occupational doses (mean monthly values, in mSv) were 1.9 (over apron); 0.3 (under apron) and 4.5 (on hands). With this National experience, a protocol was agreed among the SENTINEL partners to conduct future similar surveys in other European countries.

  6. Raynaud's disease: patient education as a primary nursing intervention.

    PubMed

    Kaufman, M W; All, A C

    1996-06-01

    The terms Raynaud's disease and Raynaud's phenomenon are often used interchangeably to identify two distinct disease states that initially appear with similar symptoms but then have very different sequelae. Triggered primarily by cold weather, both conditions commonly result in a vasospastic response predominantly observed in the fingers and toes. A review of the relevant health care literature indicates that there is little, if any, information available on Raynaud's disease that would be of particular and specific interest to the nursing profession. So that they can provide appropriate patient teaching, nurses need to be familiar with the precipitating factors, signs and symptoms, evaluation methods, and treatments of Raynaud's disease. This article focuses specifically on Raynaud's disease, which affects many women but relatively few men. A historic perspective on this disease state is provided, and postulated pathophysiologic mechanisms for the onset of this condition are addressed. The patient who is experiencing symptoms of this disease may have complaints of pain and numbness particularly in the fingers. The nurse's primary role is patient education so that the onset of symptoms associated with this disease can be identified and minimized. A discussion of nursing implications with a focus on teaching is provided. A case study is presented of a patient with Raynaud's disease, which will serve to highlight and expound on key information provided throughout the text of this article.

  7. Improving Nursing Home Communication: An Intervention To Reduce Elderspeak.

    ERIC Educational Resources Information Center

    Williams, Kristine; Kemper, Susan; Hummert, Mary Lee

    2003-01-01

    Evaluates a brief educational program designed to increase staff awareness of intergenerational speech modifications, such as elderspeak and strategies to enhance communication. After the training, Certified Nursing Assistants reduced their use of elderspeak including terms of endearment, inappropriate collective pronouns, and shortened sentence…

  8. The Effectiveness of Interventions for Improving the Research Literacy of Nurses: A Systematic Review.

    PubMed

    Hines, Sonia; Ramsbotham, Joanne; Coyer, Fiona

    2015-10-01

    Internationally, a considerable body of research exists examining why nurses do not use evidence in practice. Consistently, the research finds that lack of knowledge about research or discomfort with understanding research terminology are among the chief reasons given. Research education is commonly included in undergraduate nursing degree programs, but this does not seem to translate into a strong understanding of research following graduation, or an ability to use it in practice. The objective of this review was to identify the effectiveness of workplace, tertiary-level educational, or other interventions designed to improve or increase postregistration nurses' understanding of research literature and ability to critically interact with research literature with the aim of promoting the use of research evidence in practice in comparison to no intervention, other intervention, or usual practice. A wide range of databases were searched for quantitative studies of registered nurses receiving educational interventions designed to increase or improve their understanding of research literature in tertiary or workplace settings. Two reviewers working independently critically appraised the relevant papers and extracted the data using Joanna Briggs Institute instruments. Data are presented as a narrative summary as no meta-analysis was possible. Searching identified 4,545 potentially relevant papers, and after the sifting of titles and abstracts, 96 papers were selected for retrieval. On examination of full-text versions, 10 of the 96 retrieved papers were found to meet the inclusion criteria. Included studies were low to moderate quality. Interactive or activity-based learning seems to be effective in terms of improving research knowledge, critical appraisal ability, and research self-efficacy. Utilizing a program with a strong base in an appropriate theory also seems to be associated with greater effectiveness, particularly for workplace interventions. The included

  9. A discussion of HIV/AIDS family interventions: implications for family-focused nursing practice.

    PubMed

    Eustace, Rosemary W

    2013-07-01

    This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care. Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual-level HIV prevention, HIV/AIDS family-focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention. The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were 'nurse', or 'nursing', 'HIV/AIDS', 'family interventions', 'family support' and 'family education', and/or 'family subsystems'. The process of theorizing about 'family interventions' and 'HIV/AIDS-family interventions' is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective. Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS-FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family-focused approaches. © 2012 Blackwell Publishing Ltd.

  10. Outcomes of interventions for nurse leaders' well-being at work: A quantitative systematic review.

    PubMed

    Häggman-Laitila, Arja; Romppanen, Johanna

    2017-08-03

    The aim of this study was to gather, assess and synthesize current research knowledge on interventions that aimed to improve nurse leaders' well-being at work. The research evidence on interventions for nurse leaders' well-being at work has been sporadic and there are a lack of evidence-based recommendations for effective interventions that inform practice, future studies and education. A quantitative systematic review, in accordance with the Cochrane Collaboration procedures and the reporting guidance in the PRISMA statement. CINAHL, Cochrane, EBSCO, PubMed, PsycInfo and Scopus databases were searched from 2009 - December 2016. The final data consisted of five studies, which were assessed with the Cochrane Risk of Bias Tool. The data were summarized narratively. The interventions were mainly concerned with stress management and were targeted at individuals. Four of the five interventions examined produced statistically significant outcomes on well-being at work. Stress management interventions that included mental exercises were the most successful. Interventions primarily reduced the stress experienced by participants, but the evidence on the stability of these outcomes was poor because of the short follow-up periods. The certainty of evidence was low, indicating that the use of these interventions among nurse leaders might be beneficial. Further studies are needed to provide more reliable recommendations for their use. As the performance of nurse leaders influences organizations, through interpersonal relationships, it is important to pay more attention in the future to the development of organization- and person-directed interventions and their combinations. A structural empowerment approach should also be considered. © 2017 John Wiley & Sons Ltd.

  11. Nursing students' clinical judgment regarding rapid response: the influence of a clinical simulation education intervention.

    PubMed

    Lindsey, Pamela L; Jenkins, Sheryl

    2013-01-01

    The aim of this study was to examine the impact of a novel educational intervention on student nurses' clinical judgment regarding the management of patients experiencing rapid clinical deterioration. A randomized sample of baccalaureate nursing students enrolled in the final semester of their program at a midwestern public university participated. All students (N = 79) were pretested; the control group (n = 39) was posttested after receiving traditional code blue and rapid response education. The intervention group (n = 40) was posttested after receiving a novel education intervention. An independent t-test revealed that nursing students who received the innovative education intervention had significantly higher posttest scores (M = 90.91, standard deviation [SD] = 8.73) than did the nursing students who had not received the intervention (M = 64.80, SD = 19.69), t(77) = 7.65, p <.001). The findings demonstrate that clinical simulation is effective in improving students' knowledge and clinical judgment, specifically concerning rapid response systems. © 2013 Wiley Periodicals, Inc.

  12. [Effects of an early nursing intervention program for infants' development and mother's child rearing in poverty].

    PubMed

    Bang, Kyung-Sook

    2009-12-01

    This quasi-experimental study was performed to evaluate the effectiveness of an early nursing intervention program to support mothers of children aged 0-3 yr living in poverty. In this study, mothers who received financial support from the government were recruited from one city and assigned to an intervention group (24) and comparison group (18). They completed a baseline questionnaire about depression, child rearing burden, agreement on physical punishment, and child temperament. Also, Denver II screening of the children was performed by the researcher. Mothers in the intervention group received a home visit intervention every two weeks for three months. At 3-months post-baseline, questionnaire and Denver II screening were reused to compare these two groups. Mother's depression, child rearing burden, agreement on physical punishment, and child temperament were not significantly different between the two groups. However, the percentage of depression declined only in the intervention group. Mothers in the intervention group showed higher Home Observation for Measurement of the Environment (HOME) scores than mothers in the comparison group. The findings of the study show that this nursing intervention is an effective parenting program. The early nursing program for mothers with infant and toddlers in poverty is effective in promoting HOME, the child rearing home environment.

  13. Proposal for the Development of a Standardized Protocol for Assessing the Economic Costs of HIV Prevention Interventions

    PubMed Central

    Pinkerton, Steven D.; Pearson, Cynthia R.; Eachus, Susan R.; Berg, Karina M.; Grimes, Richard M.

    2008-01-01

    Summary Maximizing our economic investment in HIV prevention requires balancing the costs of candidate interventions against their effects and selecting the most cost-effective interventions for implementation. However, many HIV prevention intervention trials do not collect cost information, and those that do use a variety of cost data collection methods and analysis techniques. Standardized cost data collection procedures, instrumentation, and analysis techniques are needed to facilitate the task of assessing intervention costs and to ensure comparability across intervention trials. This article describes the basic elements of a standardized cost data collection and analysis protocol and outlines a computer-based approach to implementing this protocol. Ultimately, the development of such a protocol would require contributions and “buy-in” from a diverse range of stakeholders, including HIV prevention researchers, cost-effectiveness analysts, community collaborators, public health decision makers, and funding agencies. PMID:18301128

  14. Development of a nurse home visitation intervention for intimate partner violence

    PubMed Central

    2012-01-01

    Background Despite an increase in knowledge about the epidemiology of intimate partner violence (IPV), much less is known about interventions to reduce IPV and its associated impairment. One program that holds promise in preventing IPV and improving outcomes for women exposed to violence is the Nurse-Family Partnership (NFP), an evidence-based nurse home visitation program for socially disadvantaged first-time mothers. The present study developed an intervention model and modification process to address IPV within the context of the NFP. This included determining the extent to which the NFP curriculum addressed the needs of women at risk for IPV or its recurrence, along with client, nurse and broader stakeholder perspectives on how best to help NFP clients cope with abusive relationships. Methods Following a preliminary needs assessment, an exploratory multiple case study was conducted to identify the core components of the proposed IPV intervention. This included qualitative interviews with purposeful samples of NFP clients and community stakeholders, and focus groups with nurse home visitors recruited from four NFP sites. Conventional content analysis and constant comparison guided data coding and synthesis. A process for developing complex interventions was then implemented. Results Based on data from 69 respondents, an IPV intervention was developed that focused on identifying and responding to IPV; assessing a client's level of safety risk associated with IPV; understanding the process of leaving and resolving an abusive relationship and system navigation. A need was identified for the intervention to include both universal elements of healthy relationships and those tailored to a woman's specific level of readiness to promote change within her life. A clinical pathway guides nurses through the intervention, with a set of facilitators and corresponding instructions for each component. Conclusions NFP clients, nurses and stakeholders identified the need for

  15. Consequences from use of reminiscence - a randomised intervention study in ten Danish nursing homes

    PubMed Central

    2010-01-01

    Background Reminiscence is the systematic use of memories and recollections to strengthen self-identity and self-worth. The study aim was to investigate the consequences for nursing home residents and staff of integrating reminiscence into daily nursing care. Methods In this randomised study, ten nursing homes were matched into two groups on the basis of location, type and size. In the period August 2006 - August 2007, staff in the Intervention Group were trained and supported in the use of reminiscence, involving individual and group sessions with residents as well as reminiscence boxes, posters and exhibitions. At baseline and again 6 and 12 months after the intervention start, data were collected on residents' cognitive level, agitated behaviour, general functioning and proxy-assessed quality of life, as well as on staff well-being and job satisfaction. Mixed linear modelling was used to analyse differences in outcome between the intervention and control groups. Results Project drop-out rates were 32% for residents and 38% for nursing staff. Most staff in the Intervention Group considered reminiscence a useful tool that improved their communication with residents, and that they would recommend to other nursing homes. There were no significant differences between residents in the Intervention and the Control Group in cognitive level, agitated behaviour or general functioning. Residents in the Intervention Group showed significant higher score at 6 months in quality of life subscale 'Response to surroundings', but there was no significant difference at 12 months. Positive effects of reminiscence were observed for all staff outcome measures, the only exception being SF-12 self-rated physical health. At 6 months after start of reminiscence, staff in the Intervention Group had significantly better scores than those in the Control Group for Personal accomplishment, Emotional exhaustion, Depersonalisation, 'Attitude towards individual contact with residents' and SF-12

  16. Consequences from use of reminiscence--a randomised intervention study in ten Danish nursing homes.

    PubMed

    Gudex, Claire; Horsted, Charlotte; Jensen, Anders Møller; Kjer, Marianne; Sørensen, Jan

    2010-06-06

    Reminiscence is the systematic use of memories and recollections to strengthen self-identity and self-worth. The study aim was to investigate the consequences for nursing home residents and staff of integrating reminiscence into daily nursing care. In this randomised study, ten nursing homes were matched into two groups on the basis of location, type and size. In the period August 2006--August 2007, staff in the Intervention Group were trained and supported in the use of reminiscence, involving individual and group sessions with residents as well as reminiscence boxes, posters and exhibitions. At baseline and again 6 and 12 months after the intervention start, data were collected on residents' cognitive level, agitated behaviour, general functioning and proxy-assessed quality of life, as well as on staff well-being and job satisfaction. Mixed linear modelling was used to analyse differences in outcome between the intervention and control groups. Project drop-out rates were 32% for residents and 38% for nursing staff. Most staff in the Intervention Group considered reminiscence a useful tool that improved their communication with residents, and that they would recommend to other nursing homes. There were no significant differences between residents in the Intervention and the Control Group in cognitive level, agitated behaviour or general functioning. Residents in the Intervention Group showed significant higher score at 6 months in quality of life subscale 'Response to surroundings', but there was no significant difference at 12 months. Positive effects of reminiscence were observed for all staff outcome measures, the only exception being SF-12 self-rated physical health. At 6 months after start of reminiscence, staff in the Intervention Group had significantly better scores than those in the Control Group for Personal accomplishment, Emotional exhaustion, Depersonalisation, 'Attitude towards individual contact with residents' and SF-12 self-rated mental health. At

  17. Development of a nurse home visitation intervention for intimate partner violence.

    PubMed

    Jack, Susan M; Ford-Gilboe, Marilyn; Wathen, C Nadine; Davidov, Danielle M; McNaughton, Diane B; Coben, Jeffrey H; Olds, David L; Macmillan, Harriet L

    2012-02-29

    Despite an increase in knowledge about the epidemiology of intimate partner violence (IPV), much less is known about interventions to reduce IPV and its associated impairment. One program that holds promise in preventing IPV and improving outcomes for women exposed to violence is the Nurse-Family Partnership (NFP), an evidence-based nurse home visitation program for socially disadvantaged first-time mothers. The present study developed an intervention model and modification process to address IPV within the context of the NFP. This included determining the extent to which the NFP curriculum addressed the needs of women at risk for IPV or its recurrence, along with client, nurse and broader stakeholder perspectives on how best to help NFP clients cope with abusive relationships. Following a preliminary needs assessment, an exploratory multiple case study was conducted to identify the core components of the proposed IPV intervention. This included qualitative interviews with purposeful samples of NFP clients and community stakeholders, and focus groups with nurse home visitors recruited from four NFP sites. Conventional content analysis and constant comparison guided data coding and synthesis. A process for developing complex interventions was then implemented. Based on data from 69 respondents, an IPV intervention was developed that focused on identifying and responding to IPV; assessing a client's level of safety risk associated with IPV; understanding the process of leaving and resolving an abusive relationship and system navigation. A need was identified for the intervention to include both universal elements of healthy relationships and those tailored to a woman's specific level of readiness to promote change within her life. A clinical pathway guides nurses through the intervention, with a set of facilitators and corresponding instructions for each component. NFP clients, nurses and stakeholders identified the need for modifications to the existing NFP program

  18. Organisational intervention to reduce occupational stress and turnover in hospital nurses in the Northern Territory, Australia.

    PubMed

    Rickard, Greg; Lenthall, Sue; Dollard, Maureen; Opie, Tessa; Knight, Sabina; Dunn, Sandra; Wakerman, John; MacLeod, Martha; Seller, Jo; Brewster-Webb, Denise

    2012-01-01

    To evaluate the impact of an organisational intervention aimed to reduce occupational stress and turnover rates of 55% in hospital nurses. The evaluation used a pre- and post-intervention design, triangulating data from surveys and archival information. Two public hospitals (H1 and H2) in the Northern Territory (NT) Australia participated in the intervention. 484 nurses from the two NT hospitals (H1, Wave 1, N = 103, Wave 2, N = 173; H2, Wave 1, N = 75, Wave 2, N = 133) responded to questionnaires administered in 2008 and in 2010. The intervention included strategies such as the development and implementation of a nursing workload tool to assess nurse workloads, roster audits, increased numbers of nursing personnel to address shortfall, increased access to clinical supervision and support for graduates, increased access to professional development including postgraduate and short courses, and a recruitment campaign for new graduates and continuing employees. We used an extended Job Demand-Resources framework to evaluate the intervention and 17 evaluation indicators canvassing psychological distress, emotional exhaustion, work engagement, job satisfaction, job demands, job resources, and system factors such as psychosocial safety climate. Turnover rates were obtained from archival data. Results demonstrated a significant reduction in psychological distress and emotional exhaustion and a significant improvement in job satisfaction, across both hospitals, and a reduction in turnover in H2 from 2008 and 2010. Evidence suggests that the intervention led to significant improvements in system capacity (adaptability, communication) in combination with a reduction in job demands in both hospitals, and an increase in resources (supervisor and coworker support, and job control) particularly in H1. The research addresses a gap in the theoretical and intervention literature regarding system/organisation level approaches to occupational stress. The approach was very successful

  19. Virtual Nursing Intervention Adjunctive to Conventional Care: The Experience of Persons Living With HIV

    PubMed Central

    Rouleau, Geneviève; Ramirez-Garcia, Pilar; Bourbonnais, Anne

    2015-01-01

    Background Persons living with HIV (PLHIV) must adhere optimally to antiretroviral therapy (ART) on a daily basis and for their lifetime to maintain an undetectable viral load, allowing them to preserve their health. Taking advantage of the opportunity that information and communication technologies provide to broaden intervention modalities and intensify clinical follow-up, a virtual nursing intervention consisting of four interactive computer sessions was developed to empower PLHIV to manage their ART and symptoms optimally. Compared with other types of information and communication technologies-assisted interventions such as text messages, HIV Treatment, Virtual Nursing Assistance and Education (VIH-TAVIE) requires a certain degree of active engagement on the part of the user to develop and strengthen the self-management skills to optimize adherence. After the intervention’s impact on ART adherence was measured quantitatively, a qualitative study was undertaken to describe how users experience the intervention. Understanding how PLHIV perceive being assisted asynchronously by a virtual nurse was of particular interest. Objective The objective of the study was to explore and describe how PLHIV experience VIH-TAVIE, that is, receiving customized asynchronous accompaniment via a virtual nurse. Methods A qualitative study was conducted with 26 PLHIV (20 men, 6 women) who received all four VIH-TAVIE sessions. Participants had been diagnosed with HIV 14 years earlier on average and had been on ART for a mean period of 10 years. The sessions lasted 20-30 minutes each and were received two weeks apart. They are hosted by a virtual nurse who engages the user in a self-management skills-learning process for the purpose of treatment adherence. Semistructured interviews were conducted lasting 30-40 minutes to get participants to share their experience of the intervention through personal stories and what they thought and felt during their participation. Data were analyzed

  20. Managerial leadership for research use in nursing and allied health care professions: a narrative synthesis protocol.

    PubMed

    Gifford, Wendy A; Holyoke, Paul; Squires, Janet E; Angus, Douglas; Brosseau, Lucie; Egan, Mary; Graham, Ian D; Miller, Carol; Wallin, Lars

    2014-06-05

    Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours. Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use

  1. Managerial leadership for research use in nursing and allied health care professions: a narrative synthesis protocol

    PubMed Central

    2014-01-01

    Background Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours. Methods/Design Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. Discussion With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership

  2. Integration of a Palliative Care Intervention into Community Practice for Lung Cancer: A Study Protocol and Lessons Learned with Implementation.

    PubMed

    Nguyen, Huong Q; Cuyegkeng, Thomas; Phung, Tieu O; Jahn, Karisa; Borneman, Tami; Macias, Mayra; Ruel, Nora; Ferrell, Betty

    2017-06-09

    A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service models. Describe the study protocol to evaluate the dissemination of a previously tested nurse-led PC intervention (PCI) for patients with lung cancer and their family caregiver in community-based settings, lessons learned in adapting and implementing the PCI, and implications for future dissemination-translational efforts Design: Two-group, prospective sequential, quasi-experimental design with Phase 1 (Usual care) followed by Phase 2 (Intervention) setting/subjects. Three Kaiser Permanente Southern California sites. Patients with stage 2-4 nonsmall cell lung cancer and their caregiver. Standard measures of quality of life (QOL; FACT-L, FACIT- SP12, City of Hope Family QOL), symptom burden, distress, and caregiver preparedness and perceived burden. Adaptations were made to the PCI (comprehensive patient/caregiver assessment, interdisciplinary care planning, and patient/caregiver education) to harmonize with existing workflows, minimize burden to patients, caregivers, and the PC team, and maximize chances of sustainability. Implementation facilitators include external competitive pressures, internal readiness, and adaptability of the PCI. Barriers include the changing lung cancer therapeutic landscape and perceived need for PC support by patients and providers, insufficient staffing, and people-dependent processes. Efforts to disseminate and implement previously tested PC models into real-world community practices need to be more realistic and consider the local context.

  3. Weight-loss intervention using implementation intentions and mental imagery: a randomised control trial study protocol.

    PubMed

    Hattar, Anne; Hagger, Martin S; Pal, Sebely

    2015-02-27

    Overweight and obesity are major health problems worldwide. This protocol describes the HEALTHI (Healthy Eating and Active LifesTyle Health Intervention) Program, a 12-week randomised-controlled weight-loss intervention that adopts two theory-based intervention techniques, mental imagery and implementation intentions, a behaviour-change technique based on planning that have been shown to be effective in promoting health-behaviour change in previous research. The effectiveness of goal-reminder text messages to augment intervention effects will also be tested. The trial will determine the effects of a brief, low cost, theory-based weight-loss intervention to improve dietary intake and physical activity behaviour and facilitate weight-loss in overweight and obese individuals. Overweight or obese participants will be randomly allocated to one of three conditions: (1) a psycho-education plus an implementation intentions and mental imagery condition; (2) a psycho-education plus an implementation intentions and mental imagery condition with text messages; or (3) a psycho-education control condition. The intervention will be delivered via video presentation to increase the intervention's applicability in multiple contexts and keep costs low. We hypothesise that the intervention conditions will lead to statistically-significant changes in the primary and secondary outcome variables measured at 6 and 12 weeks post-intervention relative to the psycho-education control condition after controlling for baseline values. The primary outcome variable will be body weight and secondary outcome variables will be biomedical (body mass, body fat percentage, muscle mass, waist-hip circumference ratio, systolic and diastolic blood pressure, low-density lipoprotein, high-density lipoprotein, total cholesterol, triglycerides, blood glucose and insulin levels), psychological (quality of life, motivation, risk perception, outcome expectancy, intention, action self-efficacy, maintenance self

  4. Protocol for the psychotherapeutic group intervention for facilitating posttraumatic growth in nonmetastatic breast cancer patients.

    PubMed

    Ramos, Catarina; Leal, Isabel; Tedeschi, Richard G

    2016-05-04

    Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. In contrast, growing evidence has shown that posttraumatic growth can occur as a result of coping with breast cancer. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Group interventions may also increase social support, distress disclosure, and posttraumatic growth. The aim of this study is to evaluate how group-based interventions can facilitate posttraumatic growth and promote improved psychosocial adjustment to breast cancer. This article describes the study protocol and the applied research methods. To measure the impact of a group-based intervention on posttraumatic growth, a multi-center randomized control trial was developed for Portuguese breast cancer patients. 205 women with nonmetastatic breast cancer (stages 1 to 3) were recruited for the study and were randomly assigned either to the experimental group, which participated in an 8-session group intervention, or to the control group. Psychosocial variables, which consisted of posttraumatic growth, illness perception, stressfulness of the event, Posttraumatic Stress Disorder, core beliefs, rumination, social support, and distress disclosure were measured at three time points. The designated points in time for the assessments were baseline, 6 months post-intervention, and follow-up (12 months after baseline). This study is the first trial to assess the efficacy of a group-based intervention designed to facilitate posttraumatic growth following a breast cancer diagnosis. If proven to be effective, group-based intervention could be recommended as a complementary program to be included in hospital health-care and clinical practice. The trial was registered on 28/10/2013 at the Current Controlled Trials ( ISRCTN02221709 ).

  5. Use of a mobile social networking intervention for weight management: a mixed-methods study protocol.

    PubMed

    Laranjo, Liliana; Lau, Annie Y S; Martin, Paige; Tong, Huong Ly; Coiera, Enrico

    2017-07-12

    Obesity and physical inactivity are major societal challenges and significant contributors to the global burden of disease and healthcare costs. Information and communication technologies are increasingly being used in interventions to promote behaviour change in diet and physical activity. In particular, social networking platforms seem promising for the delivery of weight control interventions.We intend to pilot test an intervention involving the use of a social networking mobile application and tracking devices (Fitbit Flex 2 and Fitbit Aria scale) to promote the social comparison of weight and physical activity, in order to evaluate whether mechanisms of social influence lead to changes in those outcomes over the course of the study. Mixed-methods study involving semi-structured interviews and a pre-post quasi-experimental pilot with one arm, where healthy participants in different body mass index (BMI) categories, aged between 19 and 35 years old, will be subjected to a social networking intervention over a 6-month period. The primary outcome is the average difference in weight before and after the intervention. Secondary outcomes include BMI, number of steps per day, engagement with the intervention, social support and system usability. Semi-structured interviews will assess participants' expectations and perceptions regarding the intervention. Ethics approval was granted by Macquarie University's Human Research Ethics Committee for Medical Sciences on 3 November 2016 (ethics reference number 5201600716).The social network will be moderated by a researcher with clinical expertise, who will monitor and respond to concerns raised by participants. Monitoring will involve daily observation of measures collected by the fitness tracker and the wireless scale, as well as continuous supervision of forum interactions and posts. Additionally, a protocol is in place to monitor for participant misbehaviour and direct participants-in-need to appropriate sources of help.

  6. Screening, brief intervention, and referral to treatment (SBIRT) for offenders: protocol for a pragmatic randomized trial

    PubMed Central

    2013-01-01

    Background Although screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based technique that, in some health-care settings, has been shown to cost-effectively reduce alcohol and drug use, research on the efficacy of SBIRT among criminal offender populations is limited. Such populations have a high prevalence of drug and alcohol use but limited access to intervention, and many are at risk for post-release relapse and recidivism. Thus, there exists a need for treatment options for drug-involved offenders of varying risk levels to reduce risky behaviors or enter treatment. Methods/design This protocol describes an assessment of SBIRT feasibility and effectiveness in a criminal justice environment. Eight-hundred persons will be recruited from a large metropolitan jail, with the experimental group receiving an intervention depending on risk level and the control group receiving minimal intervention. The intervention will assess the risk level for drug and alcohol misuse by inmates, providing those at low or medium risk a brief intervention in the jail and referring those at high risk to community treatment following release. In addition, a brief treatment (eight-session) option will be available. Using data from a 12-month follow-up interview, the primary study outcomes are a reduction in drug and alcohol use, while secondary outcomes include participation in treatment, rearrest, quality of life, reduction in HIV risk behaviors, and costs of SBIRT. Expected value Individual reductions in alcohol and drug use can have significant effects on public health and safety when observed over a large population at risk for substance-use problems. With wider dissemination statewide or nationwide, a relatively low-cost intervention such as SBIRT could offer demonstrated benefits in this population. Trial registration Clinical Trials Government Identifier, NCT01683643. PMID:24499609

  7. Screening, brief intervention, and referral to treatment (SBIRT) for offenders: protocol for a pragmatic randomized trial.

    PubMed

    Prendergast, Michael L; Cartier, Jerome J

    2013-10-23

    Although screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based technique that, in some health-care settings, has been shown to cost-effectively reduce alcohol and drug use, research on the efficacy of SBIRT among criminal offender populations is limited. Such populations have a high prevalence of drug and alcohol use but limited access to intervention, and many are at risk for post-release relapse and recidivism. Thus, there exists a need for treatment options for drug-involved offenders of varying risk levels to reduce risky behaviors or enter treatment. This protocol describes an assessment of SBIRT feasibility and effectiveness in a criminal justice environment. Eight-hundred persons will be recruited from a large metropolitan jail, with the experimental group receiving an intervention depending on risk level and the control group receiving minimal intervention. The intervention will assess the risk level for drug and alcohol misuse by inmates, providing those at low or medium risk a brief intervention in the jail and referring those at high risk to community treatment following release. In addition, a brief treatment (eight-session) option will be available. Using data from a 12-month follow-up interview, the primary study outcomes are a reduction in drug and alcohol use, while secondary outcomes include participation in treatment, rearrest, quality of life, reduction in HIV risk behaviors, and costs of SBIRT. Individual reductions in alcohol and drug use can have significant effects on public health and safety when observed over a large population at risk for substance-use problems. With wider dissemination statewide or nationwide, a relatively low-cost intervention such as SBIRT could offer demonstrated benefits in this population. Clinical Trials Government Identifier, NCT01683643.

  8. Well-being, health and fitness of children who use wheelchairs: feasibility study protocol to develop child-centred 'keep-fit' exercise interventions.

    PubMed

    O'Brien, Thomas D; Noyes, Jane; Spencer, Llinos Haf; Kubis, Hans-Peter; Edwards, Rhiannon T; Bray, Nathan; Whitaker, Rhiannon

    2015-02-01

    To undertake the pre-clinical and modelling phases of the Medical Research Council complex intervention framework to underpin development of child-centred 'keep-fit', exercise and physical activity interventions for children and young people who use wheelchairs. Children who use wheelchairs face many barriers to participation in physical activity, which compromises fitness, obesity, well-being and health. 'Keep-fit' programmes that are child-centred and engaging are urgently required to enhance participation of disabled children and their families as part of a healthy lifestyle. Nurses will likely be important in promoting and monitoring 'keep-fit' intervention(s) when implemented in the community. Mixed-method (including economic analysis) feasibility study to capture child and family preferences and keep-fit needs and to determine outcome measures for a 'keep-fit' intervention. The study comprises three stages. Stage 1 includes a mixed-method systematic review of effectiveness, cost effectiveness and key stakeholder views and experiences of keep-fit interventions, followed by qualitative interviews with children, young people and their parents to explore preferences and motivations for physical activity. Stage 2 will identify standardized outcome measures and test their application with children who use wheelchairs to obtain baseline fitness data. Options for an exercise-based keep-fit intervention will then be designed based on Stage 1 and 2 findings. In stage 3, we will present intervention options for feedback and further refinement to children and parents/carers in focus groups. (Project funded October 2012). At completion, this study will lead to the design of the intervention and a protocol to test its efficacy. © 2014 John Wiley & Sons Ltd.

  9. [The effect of educational interventions on nursing team knowledge about arterial hypertension].

    PubMed

    da Silva, Stael Silvana Bagno Eleutério; Colósimo, Flávia Cortez; Pierin, Angela Maria Geraldo

    2010-06-01

    Hypertension is one of the main risk factors for cardiovascular diseases. Nursing carries a large responsibility in care delivery to hypertensive individuals. Thus, the goal was to assess a nursing team's knowledge on hypertension and its treatment before and after educational interventions. A questionnaire was used, addressing theoretical aspects of hypertension knowledge among nurses (5), technicians (2), auxiliaries (11) and community agents (37) at two Basic Health Units in São Paulo City, Brazil. For statistical analysis, Student's T test was used, as well as variance analysis and p < 0.05. A knowledge increase was verified after the educational interventions for the group constituted by nurses, technicians and nursing auxiliaries (84.6 +/- 12.0% vs. 92.7 +/- 15.0%, p < 0.05), while no significant change occurred for community health agents (80.8 +/- 12.2% vs. 83.5 +/- 24.0%). Thus, it was concluded that the educational actions were effective and must be put in practice in the nursing team, which they can influence the improvement of care delivery for hypertensive patients.

  10. A palliative care educational intervention for frontline nursing home staff: the IMPRESS project.

    PubMed

    Wen, Aida; Gatchell, Greg; Tachibana, Yukako; Tin, Maung Maung; Bell, Christina; Koijane, Jeannette; Zeri, Kenneth; Masaki, Kamal

    2012-10-01

    The purpose of this study was to examine nursing home staff perceptions of end-of-life (EOL) care skills after an educational intervention. IMPRESS (IMproving PRofessional Education and Sustaining Support) was a quality improvement EOL care educational intervention (six lectures on core palliative care concepts) for frontline nursing home staff at five community nursing homes. Questionnaires were completed to evaluate frequency of application of palliative care skills before and after the educational series. Nursing home staff reported applying palliative care skills significantly more frequently after the intervention. A significant dose-response association was noted between number of inservice sessions attended and improvement in scores: Scores increased 0.04 points for staff who attended two of the six sessions, 0.12 for four sessions attended, and 0.46 for five to six sessions attended (p = 0.03). The results indicate that frontline nursing home staff who attend inservice sessions on core palliative care topics can significantly increase self-reported application of palliative care skills.

  11. The effect of nonpharmacological training on delirium identification and intervention strategies of intensive care nurses.

    PubMed

    Öztürk Birge, Ayşegül; Tel Aydin, Hatice

    2017-08-01

    This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses. This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms. Delirium was identified in 26.5% and 20.9% of the patients in the pre- and posttraining phase, respectively. Patients with delirium had a longer duration of stay in the ICU, lower mean Glasgow Coma Scale score and a higher number of medications in daily treatment (p<0.05). The risk of delirium increased 8.5-fold by physical restriction and 3.4-fold by the presence of hypo/hypernatremia. The delirium recognition rate of nurses increased from 7.7% to 33.3% in the post-training phase. Our study results show that training can increase the efficiency of ICU nurses in the management of delirium. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. [Nursing diagnoses and interventions for patients with congestive heart failure using the ICNP ®].

    PubMed

    de Araújo, Angela Amorim; da Nóbrega, Maria Miriam Lima; Garcia, Telma Ribeiro

    2013-04-01

    The aim of this descriptive exploratory study was to construct nursing diagnosis and intervention statements for patients with Congestive Heart Failure. To accomplish this aim, 53 terms were identified in the focus axis of the International Classification for Nursing Practice (ICNP®), which guided the construction of these statements using the guidelines of the International Council of Nurses and ISO 18. 104. A total of 92 nursing diagnosis statements were constructed, which resulted in 66 statements after standardization. The standardized statements were separated according to the following pathophysiological models: 13 related to tachycardia, 20 related to dyspnea, 19 related to edema, and 14 related to congestion. A total of 234 interventions were constructed for these statements using the terms from the 7-Axis Model of the ICNP®, the literature in the area and the clinical experience of the authors. The nursing diagnosis and intervention statements designed are expected to facilitate the evaluation of CHF patients and assist in the construction of a terminological subset for the ICNP®.

  13. Hypertension in the Faith Community: A Four-Week, Nurse Led, Diet/Exercise Intervention.

    PubMed

    Bangurah, Saphie S; Vardaman, Shellye A; Cleveland, Kelli K

    Inadequate blood pressure (BP) control in hypertension carries a major financial and public health burden. This study examined the efficacy of behavioral and lifestyle changes on BP control among African American adults, aged 55 years and older in a faith-based setting. The study was supported by clergy who helped to engage participants in interventions. Nurse-led diet and exercise teaching with BP monitoring led to lower BP readings over a 4-week intervention.

  14. Interventions for nurses' well-being at work: a quantitative systematic review.

    PubMed

    Romppanen, Johanna; Häggman-Laitila, Arja

    2017-07-01

    To gather, assess and synthesize current research knowledge on the interventions aiming to improve nurses' well-being at work. Previous reviews describe health care professionals' well-being at work from the perspective of burnout. Research on the interventions for and their effectiveness on nurses' well-being at work is sporadic. A quantitative systematic review based on the procedure of the Centre for Reviews and Dissemination. CINAHL, Cochrane, EBSCO, PubMed, PsycInfo, Scopus databases were sought from 2009-March 2015. The final data consisted of eight studies described in 10 articles. The study design was RCT in three studies, CBA in three and ITS in two studies. The studies were assessed with the Cochrane risk of bias tool. Data were summarised narratively and displayed in a harvest plot. Two of the six interventions were person-directed, two combined person- and organisation-directed and two organisation-directed interventions. Half of them were mainly targeted at stress management while the others aimed at improving interaction with colleagues, work methods and conditions or at supervision of professional skills. There was a lot variation in the conceptual bases and the use of evaluation measurements in the studies and the interventions were carried out in a heterogeneous way. Moderate evidence was found to support the use of interventions among nurses employed at in-patient and out-patient units in four out of the six interventions. The review pointed out a need for research on standardised interventions on nurses' well-being at work and their effectiveness with long-term follow-ups. © 2016 John Wiley & Sons Ltd.

  15. Enhancing self-directed learning among Italian nursing students: A pre- and post-intervention study.

    PubMed

    Cadorin, L; Rei, A; Dante, A; Bulfone, T; Viera, G; Palese, A

    2015-06-01

    In accordance with Knowles's theory, self-directed learning (SDL) may be improved with tutorial strategies focused on guided reflection and critical analysis of the learning process. No evidence on effects on SDL abilities of different tutorial strategies offered to nursing students during the 1st clinical experience is available. To evaluate the effect of different tutorial strategies offered to nursing students on their SDL abilities. A pre-post intervention non-equivalent control group design was adopted in 2013. For the treatment group, structured and intensive tutorial interventions including different strategies such as briefing, debriefing, peer support, Socratic questioning, performed by university tutors were offered during the 1st clinical experience; for the control group, unstructured and non-intensive tutorial strategies were instead offered. Two Bachelor of Nursing Degree. Students awaiting their clinical experience (n=238) were the target sample. Those students who have completed the pre- and the post-intervention evaluation (201; 84.4%) were included in the analysis. SDL abilities were measured with the SRSSDL_ITA (Self Rating Scale of Self Directed Learning-Italian Version). A multiple linear regression analysis was developed to explore the predictive effect of individual, contextual and intervention variables. Three main factors explained the 36.8% of the adjusted variance in SDL scores have emerged: a) having received a lower clinical nurse-to-student supervision (B 9.086, β 2.874), b) having received higher level and structured tutorial intervention by university tutors (B 8.011, β 2.741), and c) having reported higher SDL scores at the baseline (B .550, β .556). A lower clinical nurse-to-student ratio (1:4), accompanied by unstructured and non-intensive tutorial intervention adopted by university tutors, seemed to be equivalent to an intensive clinical supervision (1:1) accompanied by higher level and structured tutorial strategies activated

  16. [Development, application and evaluation of nursing interventions for people with dementia in nursing homes in Germany--a literature review].

    PubMed

    Palm, Rebecca; Köhler, Kerstin; Dichter, Martin Nikolaus; Bartholomeyczik, Sabine; Holle, Bernhard

    2013-10-01

    In 2007 guidelines for the care of people with dementia living in nursing homes, especially for handling challenging behaviour, have been published that recommend certain interventions. The aim of this study is a systematic review of publications about projects and the development and utilisation of interventions recommended in the German guideline in German nursing homes. For this purpose, 22 publications from 8 projects were analysed. The analysis was carried out on the basis of the CReDECI-criteria for the reporting of complex interventions. The publications described the application of reminiscence-therapy, Snoezelen, Dementia Care Mapping (DCM) and the use of understanding diagnostics as well as assessment instruments. Although the interventions were based on similar theoretical frames and had the same aim they contained different components. For the implementation a considerably amount of teaching and support by the project members was needed. A process evaluation as well as information about necessary adaptations to general conditions was given seldom. Partly, information that is important for the use in practice as well as in continuative studies is missing in the publications.

  17. [Community nursing intervention in population with high-risk coronary heart disease in Hengyang].

    PubMed

    Huang, Yanjin; Chen, Jia; Zeng, Ying; Liu, Dan; He, Guoping

    2014-10-01

    To explore the effect of community nursing intervention on awareness regarding primary prevention knowledge, self-management, and risk factors for coronary heart disease (CHD) in Hengyang City, Hunan Province. A total of 120 individuals at high risk of CHD were recruited and divided into a control group and an intervention group. The intervention group was given the health knowledge lecture and individual community nursing intervention. The control group was given the routine management. Before and after the intervention, all of the recruiters were evaluated by the awareness on primary prevention knowledge, self-management and risk factors for CHD. Before the intervention, there was no significant difference in the demographic data, the cognitive levels regarding primary prevention knowledge, the self-management and the risk factors for CHD between the 2 groups (P>0.05). After the intervention, the cognitive levels regarding primary prevention knowledge, the self-management and the risk factors for CHD between the 2 groups changed. In the intervention group, the cognitive level was significantly increased (P<0.05); the self management score was improved; the systolic blood pressure, BMI, and the levels of fasting glucose, TC and low density lipoprotein-cholesterol were significantly decreased and the level of high density lipoprotein-cholesterol was significantly increased (P<0.05). There was no significant difference in the above-mentioned parameters between before and after intervention in the control group (P>0.05). The cognitive levels regarding primary prevention knowledge and self-management for CHD can be improved effectively by community nursing intervention in high-risk population of CHD, and the risk factors for CHD can also be reduced.

  18. Multifaceted nutritional intervention among nursing-home residents has a positive influence on nutrition and function.

    PubMed

    Beck, Anne Marie; Damkjaer, Karin; Beyer, Nina

    2008-01-01

    We tested the hypothesis that a multifaceted 11-wk intervention comprising nutrition, group exercise, and oral care would have a significant influence on nutrition and function in elderly (>or=65 y) nursing-home residents. The study was an 11-wk randomized controlled intervention study with nutrition (chocolate and homemade oral supplements), group exercise twice a week (45-60 min, moderate intensity), and oral care intervention one to two times a week, with the aim of improving nutritional status and function in elderly nursing-home residents. A follow-up visit was made 4 mo after the end of the intervention. Assessments were weight, body mass index, dietary intake, handgrip strength, Senior Fitness Test, Berg's Balance Scale, and the prevalence of plaque. A total of 121 subjects (61%) accepted the invitation and 62 were randomized to the intervention group. Six of these dropped out during the 11 wk. At the 4-mo follow-up there were 15 deaths in the intervention group and 8 in the control group. The nutrition and exercise were well tolerated. After 11 wk the change in percentage of weight (P = 0.005), percentage of body mass index (P = 0.003), energy intake (P = 0.084), protein intake (P = 0.012), and Berg's Balance Scale (P = 0.004) was higher in the intervention group than in the control group. In addition, the percentage of subjects whose functional tests improved was higher in the intervention group. Both groups lost the same percentage of weight after the intervention (P = 0.908). The total percentage of weight loss from baseline to follow-up was higher in the control group (P = 0.019). Oral care was not well accepted and the prevalence of plaque did not change. It is possible to improve nutrition and function in elderly nursing-home residents by means of a multifaceted intervention consisting of chocolate, homemade supplements, group exercise, and oral care.

  19. Study protocol for a web-based personalized normative feedback alcohol intervention for young adult veterans.

    PubMed

    Pedersen, Eric R; Marshall, Grant N; Schell, Terry L

    2016-03-31

    Young adult veterans from the wars in Iraq and Afghanistan represent a population at-risk for heavy and problematic alcohol use. Unfortunately, few seek treatment for alcohol concerns and those that do seek care may drop out from lengthy multicomponent treatments. Additionally, veterans who live in rural areas and those who are not engaged in the Veterans Affairs Healthcare System are often overlooked, difficult to engage in treatment, and may not be actively seeking treatment for heavy patterns of use that may develop into an alcohol use disorder. The objective of this proposed randomized controlled trial is to develop and pilot test a brief, stand-alone Internet-based alcohol intervention with young adult veterans to help them reduce their drinking and prevent the development of problematic alcohol use. Recruitment and intervention is delivered entirely over the Internet to address barriers to seeking care among this at-risk group. The online intervention consists of an assessment followed by a single module of personalized normative feedback (PNF), which provides individuals with accurate information to reduce misperceptions regarding the frequency and acceptability of risky peer behavior. PNF has established efficacy as included within multicomponent interventions targeting military populations or as a stand-alone intervention with young adult college students, but has not yet been empirically supported for the at-risk veteran population. This paper describes the development of the PNF intervention content and details the protocol for the intervention study, which will utilize a sample of 600 young adult veterans to examine the efficacy of the brief PNF intervention targeted toward reducing perceived norms, intentions to drink, actual drinking behavior, and consequences. Specific subpopulations of this veteran population, including those with mental health concerns and those differentiated by level of drinking problems, reasons for drinking, and connection to

  20. Supporting successful implementation of public health interventions: protocol for a realist synthesis.

    PubMed

    MacDonald, Marjorie; Pauly, Bernadette; Wong, Geoff; Schick-Makaroff, Kara; van Roode, Thea; Strosher, Heather Wilson; Kothari, Anita; Valaitis, Ruta; Manson, Heather; O'Briain, Warren; Carroll, Simon; Lee, Victoria; Tong, Samantha; Smith, Karen Dickenson; Ward, Megan

    2016-04-07

    There is a growing emphasis in public health on the importance of evidence-based interventions to improve population health and reduce health inequities. Equally important is the need for knowledge about how to implement these interventions successfully. Yet, a gap remains between the development of evidence-based public health interventions and their successful implementation. Conventional systematic reviews have been conducted on effective implementation in health care, but few in public health, so their relevance to public health is unclear. In most reviews, stringent inclusion criteria have excluded entire bodies of evidence that may be relevant for policy makers, program planners, and practitioners to understand implementation in the unique public health context. Realist synthesis is a theory-driven methodology that draws on diverse data from different study designs to explain how and why observed outcomes occur in different contexts and thus may be more appropriate for public health. This paper presents a realist review protocol to answer the research question: Why are some public health interventions successfully implemented and others not? Based on a review of implementation theories and frameworks, we developed an initial program theory, adapted for public health from the Consolidated Framework for Implementation Research, to explain the implementation outcomes of public health interventions within particular contexts. This will guide us through the review process, which comprises eight iterative steps based on established realist review guidelines and quality standards. We aim to refine this initial theory into a 'final' realist program theory that explains important context-mechanism-outcome configurations in the successful implementation of public health interventions. Developing new public health interventions is costly and policy windows that support their implementation can be short lived. Ineffective implementation wastes scarce resources and is

  1. A Phenomenological Study of Nurse Manager Interventions Related to Workplace Bullying.

    PubMed

    Skarbek, Anita J; Johnson, Sandra; Dawson, Christina M

    2015-10-01

    The aim of this study was to acquire nurse managers' perspectives as to the scope of workplace bullying, which interventions were deemed as effective and ineffective, and what environmental characteristics cultivated a healthy, caring work environment. Research has linked workplace bullying among RNs to medical errors, unsafe hospital environments, and negative patient outcomes. Limited research had been conducted with nurse managers to discern their perspectives. Six nurse managers from hospital settings participated in in-depth, semistructured interviews. Ray's theory of bureaucratic caring guided the study. These themes emerged: (a) awareness, (b) scope of the problem, (c) quality of performance, and (d) healthy, caring environment. Findings indicated mandated antibullying programs were not as effective as individual manager interventions. Systems must be in place to hold individuals accountable for their behavior. Communication, collective support, and teamwork are essential to create environments that lead to the delivery of safe, optimum patient care.

  2. Nursing Strategies for Promoting and Maintaining Function among Community-Living Older Adults: The CAPABLE Intervention

    PubMed Central

    Pho, Anthony T.; Tanner, Elizabeth K.; Roth, Jill; Greeley, Meghan E.; Dorsey, Carmalyn D.; Szanton, Sarah L.

    2012-01-01

    Although many programs aim to help older adults age in place, few target both the home environment and individual physical function. We present an inter-professional intervention called CAPABLE, Community Aging in Place: Advancing Better Living for Elders. CAPABLE’s innovative approach incorporates a nurse, occupational therapist (OT) and handyman to address both individual and environmental factors that contribute to disability. The nurse component of CAPABLE addresses key barriers to functional independence such as pain, depression, strength and balance, medication management and poor communication with the primary care provider. This article focuses primarily on the nursing aspect of the intervention and how it inter-relates with the content and processes of the OT and handyman. PMID:22651978

  3. [Self perception: the key stone of nursing interventions with hyperactive children].

    PubMed

    Dumas, D; Pelletier, L

    1997-01-01

    Denise Dumas, a nurse at the Hôtel-Dieu du Sacré-Coeur de Jésus hospital, in Quebec City, and Louise Pelletier, an associate professor at the Ecole des sciences infirmières of Université Laval, are interested in promoting understanding of problems linked to hyperactivity in school-age children. They suggest appropriate nursing interventions for child psychiatry units in hospitals and outpatient clinics. The authors give a definition of attention-deficit hyperactivity disorder, specifying its prevalence, etiology and treatment, and describe the behaviour of the hyperactive child. They go on to look at the concept of self-perception and deal with its development and its importance in children's lives. Most importantly, the authors suggest nursing interventions suited to the needs of hyperactive children.

  4. Surgical nurses' attitudes towards caring for patients dying of cancer - a pilot study of an educational intervention on existential issues.

    PubMed

    Udo, C; Melin-Johansson, C; Henoch, I; Axelsson, B; Danielson, E

    2014-07-01

    This is a randomised controlled pilot study using a mixed methods design. The overall aim was to test an educational intervention on existential issues and to describe surgical nurses' perceived attitudes towards caring for patients dying of cancer. Specific aims were to examine whether the educational intervention consisting of lectures and reflective discussions, affects nurses' perceived confidence in communication and to explore nurses' experiences and reflections on existential issues after participating in the intervention. Forty-two nurses from three surgical wards at one hospital were randomly assigned to an intervention or control group. Nurses in both groups completed a questionnaire at equivalent time intervals: at baseline before the educational intervention, directly after the intervention, and 3 and 6 months later. Eleven face-to-face interviews were conducted with nurses directly after the intervention and 6 months later. Significant short-term and long-term changes were reported. Main results concerned the significant long-term effects regarding nurses' increased confidence and decreased powerlessness in communication, and their increased feelings of value when caring for a dying patient. In addition, nurses described enhanced awareness and increased reflection. Results indicate that an understanding of the patient's situation, derived from enhanced awareness and increased reflection, precedes changes in attitudes towards communication. © 2014 John Wiley & Sons Ltd.

  5. Nursing Education Interventions for Managing Acute Pain in Hospital Settings: A Systematic Review of Clinical Outcomes and Teaching Methods.

    PubMed

    Drake, Gareth; de C Williams, Amanda C

    2017-02-01

    The objective of this review was to examine the effects of nursing education interventions on clinical outcomes for acute pain management in hospital settings, relating interventions to health care behavior change theory. Three databases were searched for nursing education interventions from 2002 to 2015 in acute hospital settings with clinical outcomes reported. Methodological quality was rated as strong, moderate, or weak using the Effective Public Health Practice Project Quality Assessment Tool for quantitative studies. The 12 eligible studies used varied didactic and interactive teaching methods. Several studies had weaknesses attributable to selection biases, uncontrolled confounders, and lack of blinding of outcome assessors. No studies made reference to behavior change theory in their design. Eight of the 12 studies investigated nursing documentation of pain assessment as the main outcome, with the majority reporting positive effects of education interventions on nursing pain assessment. Of the remaining studies, two reported mixed findings on patient self-report of pain scores as the key measure, one reported improvements in patient satisfaction with pain management after a nursing intervention, and one study found an increase in nurses' delivery of a relaxation treatment following an intervention. Improvements in design and evaluation of nursing education interventions are suggested, drawing on behavior change theory and emphasizing the relational, contextual, and emotionally demanding nature of nursing pain management in hospital settings.

  6. Getting Patients Walking: A Pilot Study of Mobilizing Older Adult Patients via a Nurse-Driven Intervention.

    PubMed

    King, Barbara J; Steege, Linsey M; Winsor, Katie; VanDenbergh, Shelly; Brown, Cynthia J

    2016-10-01

    To develop a system-based intervention including five components that target barriers to nurse-initiated patient ambulation. Pilot study of Mobilizing Older adult patients VIa a Nurse-driven intervention (MOVIN). Twenty-six bed general medical unit. Nursing staff (registered nurses and certified nursing assistants) were recruited to participate in focus groups. Information on frequency and distance patients ambulated and nursing staff documentation of patient ambulation were retrieved from the electronic medical record. Regression discontinuity analysis was used to determine a difference between the preintervention and intervention periods in ambulation occurrence, ambulation distance, and percentage of numeric documentation of ambulation. Thematic analysis was used to analyze focus group interviews. A statistically significant increase in number of occurrences (t = 4.18, P = .001) and total distance (t = 2.75, P = .01) and a significantly higher positive slope in percentage of numeric documentation was found during the intervention than before the intervention. Thematic analysis identified three central categories (shifting ownership, feeling supported, making ambulation visible) that describe the effect of MOVIN on nursing staff behaviors and perceptions of the intervention. Decreasing loss of independent ambulation in hospitalized older adults requires new and innovative approaches to addressing barriers that prevent nurse-initiated patient ambulation. MOVIN is a promising system-based intervention to promoting patient ambulation and improving outcomes for hospitalized older adults. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  7. Clinical Nursing Leadership Education in Long-Term Care: Intervention Design and Evaluation.

    PubMed

    Fiset, Valerie; Luciani, Tracy; Hurtubise, Alyssa; Grant, Theresa L

    2017-04-01

    The main objective of the current case study was to investigate the perceived leadership learning needs and feasibility of delivering leadership education to registered staff involved in direct care in long-term care (LTC) homes. The study was conducted in Ontario, Canada, and participants included RNs, registered practical nurses, and nursing administrators. Phase 1 bilingual web-based survey and bilingual focus group needs assessment data supported a preference for external training along with in-house mentoring to support sustainability. An intervention designed using insights gained from Phase 1 data was delivered via a 2-day, in-person workshop. Phases 2 and 3 evaluation survey data identified aspects of leadership training for LTC that require ongoing refinement. Findings suggest that communication skills and managing day-to-day nursing demands in the context of regulatory frameworks were areas of particular interest for leadership training in the LTC setting. [Journal of Gerontological Nursing, 43(4), 49-56.].

  8. Preparation of Clinical Nurse Specialists for Family-Centered Early Intervention.

    ERIC Educational Resources Information Center

    Brandt, Patricia A.; Magyary, Diane L.

    1989-01-01

    Nursing specialists are prepared at the master's level to function as members of interdisciplinary and family-centered early intervention teams for disabled children. A specialty program of study emphasizes advanced and specialized clinical practice; education of clients, families, staff, and professionals; consultation; research use; evaluation…

  9. Nursing education as an intervention to decrease fatigue perception in oncology patients.

    PubMed

    Godino, Carolina; Jodar, Lina; Durán, Angela; Martínez, Isabel; Schiaffino, Anna

    2006-04-01

    People with cancer have identified fatigue as a major obstacle to normal functioning and a good quality of life. It is a nearly universal symptom for patients undergoing primary antineoplasic therapy or treatment with biologic response modifiers (BRM) and is extremely common in patients with persistent or advanced disease. The aim of the study was to determine whether nursing education decreased the perception of fatigue in patients with colon or gastric cancer. We compared the fatigue level between two groups of patients who received the same treatment and had the same type of cancer (experimental group and control group). We provided an individualised and structured nursing intervention with education to the experimental group. We followed up the fatigue level in both groups with three different measures on the Functional Assessment of Cancer Therapy Fatigue (FACT-F) Scale. After the nursing intervention there was a decrease in the level of fatigue in the experimental group, whereas the group of patients that did not receive this intervention showed an increase in fatigue level along the treatment. The nursing intervention with the individualised education and counselling has provided patients with cancer with an effective tool to manage fatigue.

  10. An Educational Intervention to Improve Nurses' Understanding of Pain in Children in Western India.

    PubMed

    Dongara, Ashish R; Nimbalkar, Somashekhar M; Phatak, Ajay G; Patel, Dipen V; Nimbalkar, Archana S

    2017-02-01

    Accurate assessment of pain and its management is a challenging aspect of pediatric care. Nurses, usually the primary caregivers, showed inadequate knowledge and restrictive attitudes toward pain assessment. We evaluated an educational intervention to improve nurses' assessment of pain in a teaching hospital in India. A convenient sample of nurses working in the neonatal intensive care unit, pediatric ward, pediatric intensive care unit, and pediatric cardiac intensive care unit were included in the study. Workshops to improve understanding of pain, its assessment, and management strategies were conducted. A modified and consensually validated Knowledge and Attitudes Survey Regarding Pain questionnaire-2008 consisting of 25 true/false questions, eight multiple choice questions, and two case scenarios was administered before, immediately after, and 3 months after the workshops to evaluate impact of the intervention. Eighty-seven nurses participated. Mean (standard deviation) experience was 4.04 (5.9) years. Thirty-seven percent felt that they could assess pain without pain scales. About half (49.4%) of the nurses had not previously heard of pain scales, while 47.1% reported using a pain scale in their routine practice. Significant improvement was observed between pretest and post-test total scores (15.69 [2.94] vs. 17.51 [3.47], p < .001) as well as the pretest and retention score (15.69 [2.94] vs. 19.40 [4.6], p < .001). Albeit the study site and sampling frame may limit the reliability of the findings, the educational intervention was successful, and better retention test scores suggest a cascading effect. Pain assessment and management education of children should be incorporated in the nursing curriculum and should be reinforced in all pediatric units. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  11. Development of a Feasible Implementation Fidelity Protocol Within a Complex Physical Therapy-Led Self-Management Intervention.

    PubMed

    Toomey, Elaine; Matthews, James; Guerin, Suzanne; Hurley, Deirdre A

    2016-08-01

    Implementation fidelity is poorly addressed within physical therapy interventions, which may be due to limited research on how to develop and implement an implementation fidelity protocol. The purpose of this study was to develop a feasible implementation fidelity protocol within a pilot study of a physical therapy-led intervention to promote self-management for people with chronic low back pain or osteoarthritis. A 2-phase mixed-methods design was used. Phase 1 involved the development of an initial implementation fidelity protocol using qualitative interviews with potential stakeholders to explore the acceptability of proposed strategies to enhance and assess implementation fidelity. Phase 2 involved testing and refining the initial implementation fidelity protocol to develop a finalized implementation fidelity protocol. Specifically, the feasibility of 3 different strategies (physical therapist self-report checklists, independently rated direct observations, and audio-recorded observations) for assessing implementation fidelity of intervention delivery was tested, followed by additional stakeholder interviews that explored the overall feasibility of the implementation fidelity protocol. Phase 1 interviews determined the proposed implementation fidelity strategies to be acceptable to stakeholders. Phase 2 showed that independently rated audio recordings (n=6) and provider self-report checklists (n=12) were easier to implement than independently rated direct observations (n=12) for assessing implementation fidelity of intervention delivery. Good agreement (79.8%-92.8%) was found among all methods. Qualitative stakeholder interviews confirmed the acceptability, practicality, and implementation of the implementation fidelity protocol. The reliability and validity of assessment checklists used in this study have yet to be fully tested, and blinding of independent raters was not possible. A feasible implementation fidelity protocol was developed based on a 2-phase

  12. Linking Infectious and Narcology Care (LINC) in Russia: design, intervention and implementation protocol.

    PubMed

    Gnatienko, Natalia; Han, Steve C; Krupitsky, Evgeny; Blokhina, Elena; Bridden, Carly; Chaisson, Christine E; Cheng, Debbie M; Walley, Alexander Y; Raj, Anita; Samet, Jeffrey H

    2016-05-04

    Russia and Eastern Europe have one of the fastest growing HIV epidemics in the world. While countries in this region have implemented HIV testing within addiction treatment systems, linkage to HIV care from these settings is not yet standard practice. The Linking Infectious and Narcology Care (LINC) intervention utilized peer-led strengths-based case management to motivate HIV-infected patients in addiction treatment to obtain HIV care. This paper describes the protocol of a randomized controlled trial evaluating the effectiveness of the LINC intervention in St. Petersburg, Russia. Participants (n = 349) were recruited from the inpatient wards at the City Addiction Hospital in St. Petersburg, Russia. After completing a baseline assessment, participants were randomly assigned to receive either the LINC intervention or standard of care. Participants returned for research assessments 6 and 12 months post-baseline. Primary outcomes were assessed via chart review at HIV treatment locations. LINC holds the potential to offer an effective approach to coordinating HIV care for people who inject drugs in Russia. The LINC intervention utilizes existing systems of care in Russia, minimizing adoption of substantial infrastructure for implementation. Trial Registration NCT01612455.

  13. The first Australian nurse practitioner census: A protocol to guide standardized collection of information about an emergent professional group.

    PubMed

    Middleton, Sandy; Gardner, Glenn; Gardner, Anne; Della, Phillip; Gibb, Michelle; Millar, Lynne

    2010-10-01

    Internationally, collection of reliable data on new and evolving health-care roles is crucial. We describe a protocol for design and administration of a national census of an emergent health-care role, namely nurse practitioners in Australia using databases held by regulatory authorities. A questionnaire was developed to obtain data on the role and scope of practice of Australian nurse practitioners. Our tool comprised five sections and included a total of 56 questions, using 28 existing items from the National Nursing and Midwifery Labour Force Census and nine items recommended in the Nurse Practitioner Workforce Planning Minimum Data Set. Australian Nurse Registering Authorities (n = 6) distributed the survey on our behalf. This paper outlines our instrument and methods. The survey was administered to 238 authorized Australian nurse practitioners (85% response rate). Rigorous collection of standardized items will ensure health policy is informed by reliable and valid data. We will re-administer the survey 2 years following the first survey to measure change over time. © 2010 Blackwell Publishing Asia Pty Ltd.

  14. Implementing school nursing strategies to reduce LGBTQ adolescent suicide: a randomized cluster trial study protocol.

    PubMed

    Willging, Cathleen E; Green, Amy E; Ramos, Mary M

    2016-10-22

    Reducing youth suicide in the United States (U.S.) is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth are at elevated risk. The Centers for Disease Control and Prevention (CDC) endorses six evidence-based (EB) strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, "RLAS" (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide), builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS) conceptual framework and the Dynamic Adaptation Process (DAP) to implement EB strategies in U.S. high schools. The DAP accounts for the multilevel context of school settings and uses Implementation Resource Teams (IRTs) to facilitate appropriate expertise, advise on acceptable adaptations, and provide data feedback to make schools implementation ready and prepared to sustain changes. Mixed methods will be used to examine individual, school, and community factors influencing both implementation process and youth outcomes. A cluster randomized controlled trial will assess whether LGBTQ students and their peers in RLAS intervention schools (n = 20) report reductions in suicidality, depression, substance use, bullying, and truancy related to safety concerns compared to those in usual care schools (n = 20). Implementation progress and fidelity for each EB strategy in RLAS intervention schools will be examined using a modified version of the Stages of Implementation Completion checklist. During the implementation and sustainment phases, annual focus groups will be conducted with the 20 IRTs to document their experiences identifying and advancing adaptation supports to facilitate use of EB strategies and their perceptions of the DAP. The DAP represents a data-informed, collaborative, multiple stakeholder approach to progress from exploration to sustainment and obtain

  15. A peer learning intervention for nursing students in clinical practice education: A quasi-experimental study.

    PubMed

    Pålsson, Ylva; Mårtensson, Gunilla; Swenne, Christine Leo; Ädel, Eva; Engström, Maria

    2017-04-01

    Studies of peer learning indicate that the model enables students to practice skills useful in their future profession, such as communication, cooperation, reflection and independence. However, so far most studies have used a qualitative approach and none have used a quasi-experimental design to study effects of nursing students' peer learning in clinical practice. To investigate the effects of peer learning in clinical practice education on nursing students' self-rated performance. Quasi-experimental. The study was conducted during nursing students' clinical practice. All undergraduate nursing students (n=87) attending their first clinical practice were approached. Seventy students out of 87 answered the questionnaires at both baseline and follow-up (42 of 46 in the intervention group and 28 of 39 in the comparison group). During the first two weeks of the clinical practice period, all students were supervised traditionally. Thereafter, the intervention group received peer learning the last two weeks, and the comparison group received traditional supervision. Questionnaire data were collected on nursing students' self-rated performance during the second (baseline) and last (follow-up) week of their clinical practice. Self-efficacy was improved in the intervention group and a significant interaction effect was found for changes over time between the two groups. For the other self-rated variables/tests, there were no differences in changes over time between the groups. Studying each group separately, the intervention group significantly improved on thirteen of the twenty variables/tests over time and the comparison group improved on four. The results indicate that peer learning is a useful method which improves nursing students' self-efficacy to a greater degree than traditional supervision does. Regarding the other self-rated performance variables, no interaction effects were found. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Randomized Multilevel Intervention to Improve Outcomes of Residents in Nursing Homes in Need of Improvement

    PubMed Central

    Rantz, Marilyn J.; Nahm, Helen E.; Zwygart-Stauffacher, Mary; Hicks, Lanis; Mehr, David; Flesner, Marcia; Petroski, Gregory F.; Madsen, Richard W.; Scott-Cawiezell, Jill

    2012-01-01

    Purpose A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Intervention facilities (n=29) received a two-year multilevel intervention with monthly on-site consultation from expert nurses with graduate education in gerontological nursing. Attention control facilities (n=29) that also needed to improve resident outcomes received monthly information about aging and physical assessment of elders. Design and Methods Randomized clinical trial of nursing homes in need of improving resident outcomes of bladder and bowel incontinence, weight loss, pressure ulcers, and decline in activities of daily living (ADL). It was hypothesized that following the intervention, experimental facilities would have better resident outcomes, higher quality of care, higher staff retention, more organizational attributes of improved working conditions than control facilities, similar staffing and staff mix, and lower total and direct care costs. Results The intervention did improve quality of care (p=0.02); there were improvements in pressure ulcers (p=0.05), weight loss (p=0.05). Staff retention, organizational working conditions, staffing, and staff mix and most costs were not affected by the intervention. Leadership turnover was surprisingly excessive in both intervention and control groups. Implications Some facilities that are in need of improving quality of care and resident outcomes are able to build the organizational capacity to improve while not increasing staffing or costs of care. Improvement requires continuous supportive consultation and leadership willing to involve staff and work together to build the systematic improvements in care delivery needed. PMID:21816681

  17. Nurse-Led Self-Management Educational Intervention Improves Symptoms of Patients With Functional Constipation.

    PubMed

    Shen, Qiong; Zhu, Hongqin; Jiang, Guixiang; Liu, Xueqin

    2017-04-01

    This study aimed to evaluate the effects of self-management educational intervention on the symptoms of patients with functional constipation. From January 2014 to April 2015, 66 patients with functional constipation were randomly assigned into intervention group receiving intensive educational interventions and control group receiving routine nursing care. The constipation score of all clinical symptoms (Bristol stool form scale, defecation interval, incomplete evacuation, evacuatory difficulty) at 1 month postdischarge were all significantly lower in the intervention group than in the control group (all, p < .05). At 1 month postdischarge, the intervention group had a significantly higher proportion of patients with good health habits (reasonable diet, regular exercise, good defecation habits, proper use of laxatives) as compared with the control group (all, p < .05). These data suggest educational intervention can effectively improve constipation symptoms and compliance with treatment of patients, and lead to the development of good health habits.

  18. Validity, reliability and utility of the Irish Nursing Minimum Data Set for General Nursing in investigating the effectiveness of nursing interventions in a general nursing setting: A repeated measures design.

    PubMed

    Morris, Roisin; Matthews, Anne; Scott, Anne P

    2014-04-01

    Internationally, nursing professionals are coming under increasing pressure to highlight the contribution they make to health care and patient outcomes. Despite this, difficulties exist in the provision of quality information aimed at describing nursing work in sufficient detail. The Irish Minimum Data Set for General Nursing is a new nursing data collection system aimed at highlighting the contribution of nursing to patient care. The objectives of this study were to investigate the construct validity and internal reliability of the Irish Nursing Minimum Data Set for General Nursing and to assess its usefulness in measuring the mediating effects of nursing interventions on patient well-being for a group of short stay medical and surgical patients. This was a quantitative study using a repeated measures design. Participants sampled came from both general surgery and general medicine wards in 6 hospitals throughout the Republic of Ireland. Nurses took on the role of data collectors. Nurses participating in the study were qualified, registered nurses engaged in direct patient care. Because the unit of analysis for this study was the patient day, patient numbers were considered in estimations of sample size requirements. A total of 337 usable Nursing Minimum Data Set booklets were collected. The construct validity of the tool was established using exploratory factor analysis with a Promax rotation and Maximum Likelihood extraction. Internal reliability was established using the Cronbach's Alpha coefficient. Path analysis was used to assess the mediating effects of nursing interventions on patient well-being. The results of the exploratory factor analysis and path analysis met the criteria for an appropriate model fit. All Cronbach Alpha scores were above .7. The overall findings of the study inferred that the Irish Nursing Minimum Data for General Nursing possessed construct validity and internal reliability. The study results also inferred the potential of the tool in

  19. Impact of a stepwise protocol for treating pain on pain intensity in nursing home patients with dementia: A cluster randomized trial

    PubMed Central

    Sandvik, RK; Selbaek, G; Seifert, R; Aarsland, D; Ballard, C; Corbett, A; Husebo, BS

    2014-01-01

    Background Pain is frequent and distressing in people with dementia, but no randomized controlled trials have evaluated the effect of analgesic treatment on pain intensity as a key outcome. Methods Three hundred fifty-two people with dementia and significant agitation from 60 nursing home units were included in this study. These units, representing 18 nursing homes in western Norway, were randomized to a stepwise protocol of treating pain (SPTP) or usual care. The SPTP group received acetaminophen, morphine, buprenorphine transdermal patch and pregabalin for 8 weeks, with a 4-week washout period. Medications were governed by the SPTP and each participant's existing prescriptions. We obtained pain intensity scores from 327 patients (intervention n = 164, control n = 163) at five time points assessed by the primary outcome measure, Mobilization-Observation-Behaviour-Intensity-Dementia-2 (MOBID-2) Pain Scale. The secondary outcome was activities of daily living (ADL). We used a linear intercept mixed model in a two-way repeated measures configuration to assess change over time and between groups. Results The SPTP conferred significant benefit in MOBID-2 scores compared with the control group [average treatment effect (ATE) −1.388; p < 0.001] at week 8, and MOBID-2 scores worsened during the washout period (ATE = −0.701; p = 0.022). Examining different analgesic treatments, benefit was conferred to patients receiving acetaminophen compared with the controls at week 2 (ATE = −0.663; p = 0.010), continuing to increase until week 8 (ATE = −1.297; p < 0.001). Although there were no overall improvements in ADL, an increase was seen in the group receiving acetaminophen (ATE = +1.0; p = 0.022). Conclusion Pain medication significantly improved pain in the intervention group, with indications that acetaminophen also improved ADL function. What's already known about this topic? Many people with dementia experience pain

  20. Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents.

    PubMed

    Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

    2015-01-01

    to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. the development of this tool used to document the nursing actions will contribute to decision-making and quality of care.

  1. Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents1

    PubMed Central

    Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

    2015-01-01

    Objective: to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. Method: a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. Result: the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. Conclusion: the development of this tool used to document the nursing actions will contribute to decision-making and quality of care. PMID:26487144

  2. A probabilistic assessment of the impact of interventions on oncology nurses' exposure to antineoplastic agents

    PubMed Central

    Meijster, T; Fransman, W; van Hemmen, J; Kromhout, H; Heederik, D; Tielemans, E

    2006-01-01

    Objective The main goal was to investigate the potential of a probabilistic approach for exposure assessment and use this information to evaluate the impact of a complex of policy actions/interventions on dermal exposure to antineoplastic agents among oncology nurses. The central theme of this study was to make optimal use of existing data, supplemented only with limited additional information from a questionnaire survey. Methods A task based exposure model was used to estimate dermal exposure of the hands among oncology nurses in non‐academic hospitals in the Netherlands. Monte Carlo simulation was used to integrate information from available (exposure) studies and generate exposure distributions for the total population of oncology nurses in both pre‐ and post‐intervention situation. Graphs and descriptive statistics of the simulated exposure distributions were used to evaluate trends in population exposure. Results The inventory showed that important intervention occurred in the preparation and administering of antineoplastic agents and in the handling of urine. Hardly any changes were identified in de nursing tasks. The use of gloves seemed to have decreased for a number of tasks. The results of the analysis show that the interventions did not affect the median exposure. However frequencies of occurrence of individuals with very high and very low total dermal exposures decreased substantially in the post‐intervention situation. Analysis of the effect of pregnancy showed that pregnancy is very unlikely to influence exposure or any of the key input variables. Conclusions The present study shows that the probabilistic approach adds valuable information to deterministic exposure assessment, especially when extrapolating data on a subpopulation to populations of individuals at large. The results show that the identified changes in the past decade in Dutch non‐academic hospitals resulted in changes in the exposure distribution of antineoplastic agents among

  3. A probabilistic assessment of the impact of interventions on oncology nurses' exposure to antineoplastic agents.

    PubMed

    Meijster, T; Fransman, W; van Hemmen, J; Kromhout, H; Heederik, D; Tielemans, E

    2006-08-01

    The main goal was to investigate the potential of a probabilistic approach for exposure assessment and use this information to evaluate the impact of a complex of policy actions/interventions on dermal exposure to antineoplastic agents among oncology nurses. The central theme of this study was to make optimal use of existing data, supplemented only with limited additional information from a questionnaire survey. A task based exposure model was used to estimate dermal exposure of the hands among oncology nurses in non-academic hospitals in the Netherlands. Monte Carlo simulation was used to integrate information from available (exposure) studies and generate exposure distributions for the total population of oncology nurses in both pre- and post-intervention situation. Graphs and descriptive statistics of the simulated exposure distributions were used to evaluate trends in population exposure. The inventory showed that important intervention occurred in the preparation and administering of antineoplastic agents and in the handling of urine. Hardly any changes were identified in de nursing tasks. The use of gloves seemed to have decreased for a number of tasks. The results of the analysis show that the interventions did not affect the median exposure. However frequencies of occurrence of individuals with very high and very low total dermal exposures decreased substantially in the post-intervention situation. Analysis of the effect of pregnancy showed that pregnancy is very unlikely to influence exposure or any of the key input variables. The present study shows that the probabilistic approach adds valuable information to deterministic exposure assessment, especially when extrapolating data on a subpopulation to populations of individuals at large. The results show that the identified changes in the past decade in Dutch non-academic hospitals resulted in changes in the exposure distribution of antineoplastic agents among oncology nurses.

  4. Impact of Online Education on Nurses' Delivery of Smoking Cessation Interventions With Implications for Evidence-Based Practice.

    PubMed

    Bialous, Stella A; Sarna, Linda; Wells, Marjorie J; Brook, Jenny K; Kralikova, Eva; Pankova, Alexandra; Zatoński, Witold; Przewozniak, Krzysztof

    2017-02-09

    Tobacco use is the leading cause of preventable disease and death in Europe and worldwide. Nurses, if properly educated, can contribute to decreasing the burden of tobacco use in the region by helping smokers quit smoking. To assess: (a) the feasibility of an online program to educate nurses in Czech Republic and Poland on evidence-based smoking cessation interventions for patients and (b) self-reported changes in practices related to consistently (usually or always) providing smoking cessation interventions to smokers, before and 3 months after participation in the program. A prospective single-group pre-post design. A total of 280 nurses from Czech Republic and 156 from Poland completed baseline and follow-up surveys. At 3 months, nurses were significantly more likely to provide smoking cessation interventions to patients who smoke and refer patients for cessation services (p < .01). Nurses significantly improved their views about the importance of nursing involvement in tobacco control. Education about tobacco control can make a difference in clinical practice, but ongoing support is needed to maintain these changes. Health system changes can also facilitate the expectation that delivering evidence-based smoking cessation interventions should be routine nursing care. Educating nurses on cessation interventions and tobacco control is pivotal to decrease tobacco-related disparities, disease, and death. Online methods provide an accessible way to reach a large number of nurses. © 2017 Sigma Theta Tau International.

  5. Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol.

    PubMed

    Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

    2014-01-01

    With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting quantitative and qualitative findings

  6. Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol

    PubMed Central

    Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S.; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

    2014-01-01

    Aims: With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. Background: DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. Methods/Design: A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting

  7. [A correlation study of perceived importance of nursing interventions with performance frequency in psychiatric nursing units using the 3th NIC].

    PubMed

    Choi, Ja-Yun; Kim, Hye-Suk; Park, Mi-Sun

    2003-02-01

    The purpose of this study was to identify the perceived importance of nursing interventions of psychiatric nurses according to domains, classes and interventions using the 3th NIC. In this study, a 435 of 486 nursing interventions were selected from 75% consent reached by experts. Data were collected from 9 hospitals and 141 nurses(return rates : 94.0%) in Seoul, Kyonggi, Chungnam, Gwang-ju and Chonnam region from January, 2002 to February, 2002 using 4 point Likert scale. Total perceived importance score was 2.905+/-0.463 and total correlation score with performance frequency was r=0.295. The most important perceived domain and class was found to be 'safety' (3.217+/-0.465) and 'community health promotion' (3.285+/-0.866). The most correlated domain and class with performance frequency appeared to be 'behavioral' (r=0.431, p=0.000) and 'communication enhancement' (r=0.439, p=0.000). The most important perceived nursing intervention was found to be 'active listening' (3.652+/-0.549). In conclusion, nurses in clinical settings were found to perform less than perceive its importance. Therefore, further researches are needed to identify factors related to impede and develop strategies to improve the performance of nursing interventions.

  8. Development of a novel empathy-related video-feedback intervention to improve empathic accuracy of nursing students: A pilot study.

    PubMed

    Lobchuk, Michelle; Halas, Gayle; West, Christina; Harder, Nicole; Tursunova, Zulfiya; Ramraj, Chantal

    2016-11-01

    Stressed family carers engage in health-risk behaviours that can lead to chronic illness. Innovative strategies are required to bolster empathic dialogue skills that impact nursing student confidence and sensitivity in meeting carers' wellness needs. To report on the development and evaluation of a promising empathy-related video-feedback intervention and its impact on student empathic accuracy on carer health risk behaviours. A pilot quasi-experimental design study with eight pairs of 3rd year undergraduate nursing students and carers. Students participated in perspective-taking instructional and practice sessions, and a 10-minute video-recorded dialogue with carers followed by a video-tagging task. Quantitative and qualitative approaches helped us to evaluate the recruitment protocol, capture participant responses to the intervention and study tools, and develop a tool to assess student empathic accuracy. The instructional and practice sessions increased student self-awareness of biases and interest in learning empathy by video-tagging feedback. Carers felt that students were 'non-judgmental', inquisitive, and helped them to 'gain new insights' that fostered ownership to change their health-risk behaviour. There was substantial Fleiss Kappa agreement among four raters across five dyads and 67 tagged instances. In general, students and carers evaluated the intervention favourably. The results suggest areas of improvement to the recruitment protocol, perspective-taking instructions, video-tagging task, and empathic accuracy tool. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Effects of Mobility-Enhancing Nursing Intervention in Patients with MS and Stroke: Randomised Controlled Trial.

    PubMed

    Imhof, Lorenz; Suter-Riederer, Susanne; Kesselring, Jürg

    2015-01-01

    Background. Multiple sclerosis (MS) or stroke causes functional impairment which can have a major impact on patients' life. Objectives. This RCT investigated the effect of a new nursing intervention (Mobility Enhancing Nursing Intervention-MFP) designed to improve rehabilitation outcomes. Method. The study took place in a rehabilitation clinic in Switzerland. One hundred forty participants diagnosed with MS, stroke, and brain injuries were randomly assigned to control group (CG = standard care) or intervention group (IG). The IG combined standard care with 30 days of MFB. MFP placed patients on a mattress on the floor and used tactile-kinaesthetic stimulation to increase spatial orientation and independency. Outcomes were functionality (Extended Barthel Index, EBI), quality of life (WHOQoL), and fall-related self-efficacy (FES-I). Results. There was a significant main effect of the intervention on functionality (EBI-diff/day mean = 0.30, versus mean = 0.16, P = 0.008). There was also a significant main effect on QoL (WHOQoL-diff mean = 13.8, versus mean = 5.4, P = 0.046). No significant effect was observed on fall-related self-efficacy. Conclusions. The positive effect of MFP on rehabilitation outcomes and quality of life suggests that this specialized nursing intervention could become an effective part of rehabilitation programs. The study was approved by the Ethics Committee of St. Gallen (KEK-SG Nr. 09/021) and registered at ClinicalTrial.gov NCT02198599.

  10. Personal resilience in nurses and midwives: effects of a work-based educational intervention.

    PubMed

    McDonald, Glenda; Jackson, Debra; Wilkes, Lesley; Vickers, Margaret H

    2013-08-01

    Nurses and midwives commonly face a variety of challenges and difficulties in their everyday work. Stress, pressure, fatigue and anxiety are acknowledged sources of workplace adversity, which causes decreased perceptions of health and wellbeing. This study reports the effects of a work-based, educational intervention to promote personal resilience in a group of 14 nurses and midwives working in a busy clinical environment. The intervention encouraged participants to focus on the key characteristics of a resilient person and the elements that assisted them in their maintenance of personal resilience. The intervention also explored potential strategies for the future. Opportunities were provided for experiential learning, creative self-expression and exposure to new ideas. Primary effects of the intervention were found to benefit the participants in personal and professional areas; by enhanced confidence, self-awareness, assertiveness and self-care. This intervention had implications for the education and practice of nurses and midwives in terms of building and maintaining their personal resilience, especially those exposed to workplace adversity.

  11. Nursing Students' and Tutors' Satisfaction With a New Clinical Competency System Based on the Nursing Interventions Classification.

    PubMed

    Iglesias-Parra, Maria Rosa; García-Mayor, Silvia; Kaknani-Uttumchandani, Shakira; León-Campos, Álvaro; García-Guerrero, Alfonso; Morales-Asencio, José Miguel

    2016-10-01

    To assess students' satisfaction with their clinical tutors, their clinical practices, and tutors' satisfaction with the new approach of clinical placements and tutorship. A cross-sectional study was used, with a study population of second and third year nursing students and clinical tutors. Global satisfaction was 7.47 (SD 1.61) (range from 1 to 9). Regarding students' satisfaction, 75.67% of the items were equal to or greater than 4 (range from 1 to 5). The overall mean score was 4.05 (DE 1.08). A competency-structured practicum, assessed through the Nursing Interventions Classification and supported on information and communications technologies, is a reliable and valid method that encourages students and tutors to an active participation, and implies a high degree of satisfaction in both tutors and students. © 2015 NANDA International, Inc.

  12. Analysis of a Low Dose Protocol to Reduce Patient Radiation Exposure During Percutaneous Coronary Interventions.

    PubMed

    Maccagni, Davide; Godino, Cosmo; Latib, Azeem; Azzalini, Lorenzo; Pazzanese, Vittorio; Chieffo, Alaide; Margonato, Alberto; Colombo, Antonio

    2017-01-15

    The cardiac catheterization laboratory is an important source of radiation for patients and operators and it is good practice to limit exposure as much as possible. The purpose of this study was to evaluate the effectiveness and impact of a radiological low dose protocol (LDP) in terms of reduction in patient radiation exposure during percutaneous coronary interventions (PCIs). From November 2014 to October 2015, 906 consecutive patients who underwent PCI were evaluated. Of these, 571 patients (63%) were treated with the standard dose protocol (SDP) of 15 frames per second for cine acquisition and standard settings for fluoroscopy, and 335 patients (37%) with the LDP of 7.5 frames per second for cine acquisition and low-dose settings for fluoroscopy. In the LDP group, we observed a significant reduction of kerma area product (53.3 LDP vs 115 SDP Gycm(2), p <0.0001) and air kerma at interventional reference point (0.79 LDP vs 1.976 SDP Gy, p <0.0001). Marked differences were observed regarding the exceeding of International Commission on Radiological Protection and National Council on Radiation Protection and Measurements' air kerma at interventional reference point trigger level (cutoff for potential skin injuries), which were significantly lower in the LDP group (1.8% vs 7.2%, p <0.0001). Such difference was more relevant in complex PCI. In conclusion, the implementation of LDP allowed a marked reduction in patient dosimetric parameters for PCI and significantly reduced the risk of exceeding the International Commission on Radiological Protection/National Council on Radiation Protection and Measurements trigger levels for potential skin injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. A person-centered care intervention for geriatric certified nursing assistants.

    PubMed

    Coleman, Carissa K; Medvene, Louis J; Van Haitsma, Kimberly

    2013-08-01

    To pilot test a multicomponent intervention to increase certified nursing assistants' (CNAs) awareness of person-centered care. To establish the feasibility of implementing an intervention involving videotaped biographies of residents and videotapes of resident/CNA caregiving interactions. A training program was provided at two nursing homes (NHs) using a wait-list control design. Levels of dyadic relationship closeness and satisfaction were compared prepost. Video recordings of CNA/resident interactions were coded for person-centered care using two observational instruments. Based on data from 19 resident/aide dyads, the findings were that resident's perceptions of relationship closeness increased significantly posttraining at both NHs, NH1, z = -1.89, p < .05, and the NH2, z = -1.95, p < .05. Effects were also seen with the CNA's perceptions of satisfaction and closeness, and resident satisfaction. The findings suggest that this type of intervention is feasible and warrants further research.

  14. The effectiveness of workplace dietary interventions: protocol for a systematic review and meta-analysis.

    PubMed

    Smith, Sarah A; Lake, Amelia A; Summerbell, Carolyn; Araujo-Soares, Vera; Hillier-Brown, Frances

    2016-02-03

    The lack of evidence of the role of workplaces as settings for behaviour change delivery and the failure to recognise and address the complexity of the work environment has been acknowledged. This systematic review and meta-analysis will identify the effectiveness of dietary interventions in the workplace facilitating an understanding of what works, why and how by identifying key components of and examining the theoretical models of behaviour change underpinning successful dietary interventions in the workplace. We will conduct searches in MEDLINE, EMBASE, CINAHL, PsycINFO, CENTRAL and PubMed for studies that assess dietary interventions based within workplace settings in any country, of any length of time or duration of follow-up. We will include all randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after studies (CBAs) and interrupted time series (ITS) studies with a control group. Risk of bias of included studies will be assessed using a tool adapted from the Cochrane Public Health Review Group's recommended Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Meta-analysis will be conducted if appropriate, or a narrative synthesis will be conducted following the ESRC Narrative Synthesis Guidance. This paper outlines the study protocol for a systematic review and meta-analysis that will identify, critically appraise, and summarise the relevant evidence on the effectiveness and implications of interventions to promote healthier dietary behaviours in the workplace. This review will give an overview of the evidence and provide a guide for development of interventions promoting dietary behaviour change in workplaces. PROSPERO CRD42015015175.

  15. Protocol for an overview of systematic reviews of interventions to reduce unscheduled hospital admissions among adults.

    PubMed

    Bobrovitz, Niklas; Onakpoya, Igho; Roberts, Nia; Heneghan, Carl; Mahtani, Kamal R

    2015-08-21

    Unscheduled hospital admissions are an increasing burden on health systems worldwide. To date, initiatives to reduce admissions have had limited success as it is unclear which strategies effectively reduce admissions and are supported by a strong evidence-base. Therefore, we will conduct an overview to find, assess and summarise all published peer-reviewed systematic reviews of randomised controlled trials that examine the effect of an intervention on unplanned admissions among adults. This is a protocol for a systematic overview of reviews. We will search four databases: Ovid MEDLINE, PubMed, Cochrane Database of Systematic Reviews and the Cochrane Database of Abstracts of Reviews of Effects. We will consider systematic reviews and meta-analyses of randomised controlled trials in adults (≥ 16 years old) evaluating the effect of any intervention on unscheduled hospital admissions including those to treat, monitor, diagnose or prevent a health problem. We will only include reviews that identified unscheduled hospitalisations as a prespecified outcome. Two authors will independently screen articles for inclusion using a priori criteria. We will assess the quality of included reviews and extract ratings of the quality of evidence from within each review. We will create a hierarchical list of interventions based on estimates of absolute admission reductions and the quality of the evidence. Presentation of results will align with guidelines in the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Ethics approval is not required. We will submit the results of this study for peer-review publication. The results will inform future research and could be used by healthcare managers, administrators and policymakers to guide resource allocation decisions and inform local implementation and optimisation of interventions to reduce unscheduled hospital admissions. Published by the BMJ

  16. Rehabilitation interventions in children and adults with infectious encephalitis: a systematic review protocol

    PubMed Central

    Christie, Shanice; Chan, Vincy; Mollayeva, Tatyana; Colantonio, Angela

    2016-01-01

    Introduction Many encephalitis survivors can benefit from rehabilitation. However, there is currently no comprehensive review describing rehabilitation intervention outcomes among children and adults with infectious encephalitis. This is a protocol for a systematic review that will summarise the current literature on outcomes following rehabilitative interventions among children and adults with infectious encephalitis. With a sufficient sample size, a sex-stratified analysis of the findings will also be presented, as variability between male and female patients with neurological disorders, including encephalitis, regarding outcomes after rehabilitative interventions has been noted in the literature. Methods and analysis This review will systematically search MEDLINE, MEDLINE In-Process, EMBASE, Cochrane Central Register of Controlled Trials, and PsycINFO using the concepts ‘encephalitis’ and ‘rehabilitation’. Grey literature will be searched using Grey Matters: A practical search tool for evidence-based medicine and the Google search engine. In addition, reference lists of eligible articles will be screened for any relevant studies. 2 reviewers will independently evaluate the retrieved studies based on predetermined eligibility criteria and perform a quality assessment on eligible studies. Ethics and dissemination The results from this review hold the potential to advance our knowledge on the value of rehabilitative interventions targeting children and adults with infectious encephalitis and any sex differences among patients with regard to rehabilitative intervention outcomes. The authors will publish findings from this review in a peer-reviewed scientific journal (electronic and in-print) and present the results at national and international conferences. Trial registration number CRD42015029217. PMID:27013598

  17. Nursing staff's communication modes in patient transfer before and after an educational intervention.

    PubMed

    Kindblom-Rising, Kristina; Wahlstrom, Rolf; Ekman, Sirkka-Liisa; Buer, Nina; Nilsson-Wikmar, Lena

    2010-10-01

    The objective was to explore and describe nursing staff's body awareness and communication in patient transfers and evaluate any changes made after an educational intervention to promote staff competence in guiding patients to move independently. In total, 63 nursing staff from two hospitals wrote weekly notes before and after the intervention. The topics were: A) reflect on a transfer during the last week that you consider was good and one that was poor; B) reflect on how your body felt during a good and a poor transfer. The notes were analysed with content analysis. The results showed five different communication modes connected with nursing staff's physical and verbal communication. These communication modes changed after 1 year to a more verbal communication, focusing on the patient's mobility. The use of instructions indicated a new or different understanding of patient transfer, which may contribute to a development of nursing staff's competence. STATEMENT OF RELEVANCE: The present findings indicate that patient transfer consists of communication. Therefore, verbal and bodily communication can have an integral part of training in patient transfer; furthermore, the educational design of such programmes is important to reach the goal of developing new understanding and enhancing nursing staff's competence in patient transfer.

  18. The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI) randomized controlled trial protocol

    PubMed Central

    2013-01-01

    Background Because of symptoms, people with lumbar spinal stenosis (LSS) are often inactive, and this sedentary behaviour implies risk for diseases including obesity. Research has identified body mass index as the most powerful predictor of function in LSS. This suggests that function may be improved by targeting weight as a modifiable factor. An e-health lifestyle intervention was developed aimed at reducing fat mass and increasing physical activity in people with LSS. The main components of this intervention include pedometer-based physical activity promotion and nutrition education. Methods/Design The Spinal Stenosis Pedometer and Nutrition Lifestyle Intervention (SSPANLI) was developed and piloted with 10 individuals. The protocol for a randomized controlled trail comparing the SSPANLI intervention to usual non-surgical care follows. One hundred six (106) overweight or obese individuals with LSS will be recruited. Baseline and follow-up testing includes dual energy x-ray absorptiometry, blood draw, 3-day food record, 7-day accelerometry, questionnaire, maximal oxygen consumption, neurological exam, balance testing and a Self-Paced Walking Test. Intervention: During Week 1, the intervention group will receive a pedometer, and a personalized consultation with both a Dietitian and an exercise specialist. For 12 weeks participants will log on to the e-health website to access personal step goals, walking maps, nutrition videos, and motivational quotes. Participants will also have access to in-person Coffee Talk meetings every 3 weeks, and meet with the Dietitian and exercise specialist at week 6. The control group will proceed with usual care for the 12-week period. Follow-up testing will occur at Weeks 13 and 24. Discussion This lifestyle intervention has the potential to provide a unique, non-surgical management option for people with LSS. Through decreased fat mass and increased function, we may reduce risk for obesity, chronic diseases of inactivity, and pain

  19. Interventional patient hygiene model: Infection control and nursing share responsibility for patient safety.

    PubMed

    McGuckin, Maryanne; Shubin, Arlene; Hujcs, Marianne

    2008-02-01

    Interventional patient hygiene (IPH) has been defined as a comprehensive evidence-based intervention and measurement model for reducing the bioburden of both the patient and health care worker. The components of IPH are hand hygiene, oral care, skin care/antisepsis, and catheter site care. This practice form will provide evidence-based information for each of the components of IPH model and provide a strategy for the development, implementation, and monitoring of IPH protocols.

  20. Creating a Nurse-Led Culture to Minimize Horizontal Violence in the Acute Care Setting: A Multi-Interventional Approach.

    PubMed

    Parker, Karen M; Harrington, Ann; Smith, Charlene M; Sellers, Kathleen F; Millenbach, Linda

    2016-01-01

    Horizontal violence (HV) is prevalent in nursing. However, few strategies are identified to address this phenomenon that undermines communication and patient safety. Nurses at an acute care hospital implemented multiple interventions to address HV resulting in increased knowledge of hospital policies regarding HV, and significantly (p < .05) less HV prevalence than was reported by nurses in other organizations throughout New York State. With the aid and oversight of nursing professional development specialists, evidence-based interventions to address HV were developed including policies, behavioral performance reviews, and staff/manager educational programs.

  1. An internet-based adolescent depression preventive intervention: study protocol for a randomized control trial.

    PubMed

    Gladstone, Tracy G; Marko-Holguin, Monika; Rothberg, Phyllis; Nidetz, Jennifer; Diehl, Anne; DeFrino, Daniela T; Harris, Mary; Ching, Eumene; Eder, Milton; Canel, Jason; Bell, Carl; Beardslee, William R; Brown, C Hendricks; Griffiths, Kathleen; Van Voorhees, Benjamin W

    2015-05-01

    The high prevalence of major depressive disorder in adolescents and the low rate of successful treatment highlight a pressing need for accessible, affordable adolescent depression prevention programs. The Internet offers opportunities to provide adolescents with high quality, evidence-based programs without burdening or creating new care delivery systems. Internet-based interventions hold promise, but further research is needed to explore the efficacy of these approaches and ways of integrating emerging technologies for behavioral health into the primary care system. We developed a primary care Internet-based depression prevention intervention, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training (CATCH-IT), to evaluate a self-guided, online approach to depression prevention and are conducting a randomized clinical trial comparing CATCH-IT to a general health education Internet intervention. This article documents the research framework and randomized clinical trial design used to evaluate CATCH-IT for adolescents, in order to inform future work in Internet-based adolescent prevention programs. The rationale for this trial is introduced, the current status of the study is reviewed, and potential implications and future directions are discussed. The current protocol represents the only current, systematic approach to connecting at-risk youth with self-directed depression prevention programs in a medical setting. This trial undertakes the complex public health task of identifying at-risk individuals through mass screening of the general primary care population, rather than solely relying on volunteers recruited over the Internet, and the trial design provides measures of both symptomatic and diagnostic clinical outcomes. At the present time, we have enrolled N = 234 adolescents/expected 400 and N = 186 parents/expected 400 in this trial, from N = 6 major health systems. The protocol described here provides a model

  2. Effects of psychological nursing intervention on personality characteristics and quality of life of patients with esophageal cancer.

    PubMed

    Cheng, Qiao-mei; Kong, Cun-quan; Chang, Shu-ying; Wei, Ai-huan

    2013-06-01

    This study examined the effects of a psychological nursing intervention on personality characteristics and quality of life of esophageal cancer patients. Esophageal cancer patients (n=86) were randomized into either an intervention group (n=45) or a control group (n=41). Patients in the control group were given routine nursing care, and those in the intervention group were provided with psychological nursing interventions in addition to routine nursing care. Personality characteristics, assessed through Eysenck Personality Questionnaire, and quality of life, assessed through EORTC QLQ-C30, were compared between the two groups. The results showed that personality characteristics were closely related to quality of life. After the psychological nursing intervention, the main factors were neurosis, psychosis or mood instability, and personality stability. However, introverted and extroverted personality characteristics were not associated with quality of life. The psychological nursing intervention was associated with decreased P-scale and E-scale scores of personality characteristics and improved quality of life in each dimension scored. A psychological nursing intervention can affect the personality characteristics of esophageal cancer patients and improve their quality of life; this approach is worthy of further study and clinical application. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  3. A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.

    PubMed

    Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G

    2015-01-01

    The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

  4. Nurse Case Management and Housing Interventions Reduce Allergen Exposures: The Milwaukee Randomized Controlled Trial

    PubMed Central

    Breysse, Jill; Wendt, Jean; Dixon, Sherry; Murphy, Amy; Wilson, Jonathan; Meurer, John; Cohn, Jennifer; Jacobs, David E.

    2011-01-01

    Objective We examined the impact of a combination of home environmental interventions and nurse case management services on total settled dust loadings and on allergen concentrations in the homes of asthmatic children. Methods Using a randomized longitudinal controlled trial study design, we randomly assigned homes of asthmatic children in Milwaukee to either a control (n=64) or an intervention (n=57) group. Control group homes received a visual assessment, education, bed/pillow dust mite encasings, and treatment of lead-based paint hazards. The intervention group received these same services plus nurse case management that included tailored, individual asthma action plans, provision of minor home repairs, home cleaning using special vacuuming and wet washing, and integrated pest management. Dust vacuum samples were collected from measured surface areas of floors in the TV room, kitchen, and child's bedroom at baseline and at three-, six-, and 12-month follow-up visits. Dust loading (mass per surface area) is a means of measuring total dust and the total amount of allergen present. Results For the intervention group, geometric mean dust loadings declined significantly from baseline (39 milligrams per square foot [mg/ft2]) to post-intervention (11 mg/ft2) (p<0.001). Baseline dust loading, treatment group, visit, and season were significant predictors of follow-up dust loadings. Mean post-intervention dust loadings were 72% higher in the control group. The total amount of allergen in settled house dust declined significantly following the